Prevalence and Predictors of Vitamin D Deficiency and Response to Oral Supplementation in Patients Receiving Long-Term Home Parenteral Nutrition. (October 2014)

• Record Type: Journal Article
• Authors: Bharadwaj, Shishira; Gohel, Tushar D.; Deen, Omer J.; Coughlin, Kathleen L.; Corrigan, Mandy L.; Fisher, Jill; Lopez, Rocio; Shatnawei, Abdullah; Kirby, Donald F.
• Is Part Of: Nutrition in clinical practice. Volume 29:Number 5(2014:Oct.)
• Page Start: 681
• Page End: 685
• Publication Date: 2014-10
• Subjects: total parenteral nutrition -- vitamin D deficiency -- avitaminosis -- home parenteral nutrition -- vitamin D; Nutrition -- Periodicals; Diet therapy -- Periodicals; Artificial feeding -- Periodicals; 615.854
• DOI: 10.1177/0884533614539178
• Languages: English
• ISSNs: 0884-5336

Abstract

Previous studies have suggested a high prevalence of vitamin D deficiency in patients receiving long-term home parenteral nutrition (HPN). The aim of this study was to determine the prevalence and predictors of vitamin D deficiency in long-term HPN patients. Methods : A retrospective, institutional review board–approved study was performed on all adult patients followed by the Cleveland Clinic HPN program receiving HPN therapy >6 months between 1989 and 2013 with a 25-(OH) D3 level reported. Patients were categorized by serum vitamin D status as follows: sufficient, insufficient, and deficient with respective 25-(OH) D3 levels of ≥30 ng/mL, 20–30 ng/mL, and <20 ng/mL. Results : Seventy-nine patients were categorized based on serum vitamin D status as follows: 35 (44.3%) deficient, 24 (30.4%) insufficient, and 20 (25.3%) sufficient. The mean age of the cohort at the initiation of HPN was 52.0 ± 12.7 years, and 26 (32.9%) were male. The median HPN duration was 39 months, and the most common indication was inflammatory bowel disease (36.7%). Most (82.3%) patients had at least 1 prescription of oral vitamin D supplement (50, 000 International Units) during this time. History of jejunal resection (odds ratio [OR], 5.3; 95% confidence interval [CI], 1.9–15.1; P = .002) and lack of oral vitamin D supplementation (OR, 0.7; 95% CI, 0.52–0.93; P = .038) were the strongest predictors of vitamin D deficiency. Conclusion : Vitamin D deficiency is common among patients receiving long-term HPN despite oral supplementation.