High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition
High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition
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即使在戒断肠外营养后，成人短肠综合症中维生素 D 状态不佳和骨质流失的患病率也很高
DOI：
10.1177/0884533616665784
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发表时间：
2017-04
影响因子：
3.1
通讯作者：
Jieshou Li
中科院分区：
文献类型：
--
作者：
Shen Tao;Wencheng Kong;Yousheng Li;Jieshou Li
背景：先前的研究已经注意到短肠综合征(SBS)合并肠外营养(PN)依赖时，维生素D(VTD)状态不佳和骨质丢失的发生率很高。然而，有限的数据集中在没有PN依赖的成人SBS上。因此，我们的目标是调查成人SBS脱机后VTD状态不佳和骨质丢失的发生率和危险因素。材料和方法：我们对60例成人SBS患者进行了前瞻性研究。采用放射免疫法测定血清25-羟基维生素D(25-OHD)水平。采用双能X线骨密度仪(DEXA)测量骨密度。收集所有参与者的医疗记录和各种实验室参数。结果：所有患者的VTD状态均不理想，其中VTD不足3例(5.0%)，VTD缺陷57例(95.0%)。残存小肠长度(B，0.072，P=.001)和肠痉挛持续时间(B，-0.066，P=.020)均与VTD水平不佳显著相关。总体而言，只有2名患者骨密度正常；41名患者(68.3%)和17名患者(28.3%)分别出现骨量减少和骨质疏松。低25-OHD浓度与骨密度降低相关(B，0.065，P=.029)。没有其他人口学特征或临床检查与不理想的VTD水平和骨丢失相关。结论：成人SBS的VTD状态和骨质丢失在脱机后仍很常见。尽管常规的口服VTD补充，大多数患者并没有达到满意的状态。这强调了常规监测25-OHD和BMD的极端重要性，以及考虑在脱机后补充营养的替代方法。
Background: Previous studies have noticed the high incidence of suboptimal vitamin D (VtD) status and bone loss in short bowel syndrome (SBS) with parenteral nutrition (PN) dependence. However, limited data have focused on adult SBS without PN dependence. Therefore, our objective was to investigate the incidence and risk factors of suboptimal VtD status and bone loss in adult SBS even after weaning off PN. Materials and Methods: We performed a prospective study of 60 adult patients with SBS. Serum 25-hydroxyvitamin D (25-OHD) was measured by radioimmunoassay. Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry (DEXA). Medical records and various laboratory parameters were collected in all participants. Results: Suboptimal VtD status was identified in all individuals, including 3 (5.0%) with VtD insufficiency and 57 (95.0%) with VtD deficiency. Residual small bowel length (B, 0.072, P = .001) and duration of SBS (B, –0.066, P = .020) were both significantly correlated with suboptimal VtD levels. Overall, only 2 patients presented a normal BMD; osteopenia and osteoporosis were noted in 41 (68.3%) and 17 (28.3%) individuals, respectively. Low 25-OHD concentration was associated with a decreased BMD (B, 0.065, P = .029). There were no other demographic characteristics or clinical examinations associated with suboptimal VtD levels and bone loss. Conclusion: Suboptimal VtD status and bone loss were common in adult SBS even after weaning off PN. Despite routine oral VtD supplementation, most patients did not achieve satisfactory status. This emphasizes the critical importance of routine surveillance of 25-OHD and BMD, as well as consideration of alternative methods of supplementation after weaning off PN.
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DOI：
10.1177/0148607110386964
发表时间：
2011-07
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
C. Braga;H. Vannucchi;C. Freire;J. Marchini;A. Jordão;S. F. da Cunha
通讯作者：
C. Braga;H. Vannucchi;C. Freire;J. Marchini;A. Jordão;S. F. da Cunha
DOI：
10.1177/0148607110381269
发表时间：
2011-07
期刊：
JPEN. Journal of parenteral and enteral nutrition
影响因子：
--
作者：
P. Thomson;D. Duerksen
通讯作者：
P. Thomson;D. Duerksen
影响因子：
--
作者：
T. Oppé
通讯作者：
T. Oppé
DOI：
10.1007/978-1-60327-303-9_14
发表时间：
2010
期刊：
--
影响因子：
--
作者：
H. Cross;M. Peterlik
通讯作者：
H. Cross;M. Peterlik
影响因子：
3.2
作者：
Mutanen, Annika;Makitie, Outi;Pakarinen, Mikko P.
通讯作者：
Pakarinen, Mikko P.