Vitamin D status in children, adolescents, and young adults with Crohn disease
Vitamin D status in children, adolescents, and young adults with Crohn disease
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DOI：
10.1093/ajcn/76.5.1077
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发表时间：
2002-11-01
影响因子：
7.1
通讯作者：
Zemel, BS
中科院分区：
文献类型：
--
作者：
Sentongo, TA;Semaeo, EJ;Zemel, BS
背景：克罗恩病（CD）和维生素D缺乏与骨矿化减少有关。目的：研究儿童、青少年和年轻CD患者维生素D缺乏症的患病率及其危险因素。设计：对112名年龄在5-22岁的CD患者（44名女性）进行横断面研究，测量其生长、临床特征、维生素D摄入量（马克杯/天）和骨密度（克/厘米(2)）。维生素缺乏症D定义为血清25-羟基维生素D [25(OH)D]浓度< 38 nmol/L。结果:意思是(+ / -标准差)血清25 (OH) D的浓度为59.7 + / - 26.9 nmol / L,和16% (95% CI: 9.3%、23%)的受试者维生素缺乏D .维生素缺乏D是冬季最流行(31%,P = 0.02),在非裔美国人(56%,P = 0.01),在受试者CD局限于上消化道(44%,P = 0.05),和更大的一生暴露在糖皮质激素治疗(23.7 + / - 13.5与17.5 + / - 12.2 mg / D; P = 0.05)。维生素D缺乏症与骨密度（P = 0.10）和平均膳食维生素D摄入量（4.6 +/- 3.6 μg/ D, P = 0.87）均无相关性。结论：在这个患有乳糜泻的儿科患者样本中，维生素D缺乏症很常见，并且与冬季、非裔美国人种族、乳糜泻局限于上胃肠道以及终生接受糖皮质激素治疗的程度有关。这些因素的出现应及时评估25(OH)D状态，并通过补充低血清浓度受试者优化临床护理。种族对乳糜泻儿童25(OH)D状态的生理相关性仍有待确定。
Background: Crohn disease (CD) and vitamin D deficiency are associated with decreased bone mineralization.Objective: We examined the prevalence of and risk factors for hypovitaminosis D in children, adolescents, and young adults with CD.Design: Growth, clinical characteristics, vitamin D intake (mug/d), and bone mineral density (g/cm(2)) were measured in a cross-sectional study of 112 subjects (44 females) who had CD and were 5-22 y of age. Hypovitaminosis D was defined as a serum concentration of 25-hydroxyvitamin D [25(OH)D] < 38 nmol/L.Results: The mean (+/-SD) serum concentration of 25(OH)D was 59.7 +/- 26.9 nmol/L, and 16% (95% CI: 9.3%, 23%) of the subjects had hypovitaminosis D. Hypovitaminosis D was most prevalent during the winter (31%; P = 0.02), among the African Americans (56%; P = 0.01), in the subjects with CD confined to the upper gastrointestinal tract (44%; P = 0.05), and in the subjects with a greater lifetime exposure to glucocorticoid therapy (23.7 +/- 13.5 compared with 17.5 +/- 12.2 mg/d; P = 0.05). There was no association between hypovitaminosis D and either bone mineral density (P = 0.10) or average dietary intake of vitamin D (4.6 +/- 3.6 μg/d; P = 0.87).Conclusions: In this sample of pediatric patients with CD, hypovitaminosis D was common and was associated with the winter season, African American ethnicity, CD confined to the upper gastrointestinal tract, and magnitude of lifetime exposure to glucocorticoid therapy. The occurrence of these factors should prompt assessment of 25(OH)D status and clinical care optimized by supplementing subjects who have low serum concentrations. The physiologic relevance of ethnicity on 25(OH)D status in children with CD remains to be determined.