The Frequency of Vitamin D Deficiency in Adults with Crohn's Disease. (1st August 2003)

• Record Type: Journal Article
• Authors: Siffledeen, Jesse S; Siminoski, Kerry; Steinhart, Hillary; Greenberg, Gordon; Fedorak, Richard N
• Is Part Of: Canadian Journal of Gastroenterology. Volume 17:Number 8(2003)
• Page Start: 473
• Page End: 478
• Publication Date: 2003-08-01
• Subjects: Bone mineral density -- Crohn's disease -- Inflammatory bowel disease -- Osteopenia -- Osteoporosis -- Vitamin D
• DOI: 10.1155/2003/391308
• Languages: English
• ISSNs: 0835-7900

Abstract

Abstract : BACKGROUND: Vitamin D deficiency is a putative, pathogenic cofactor in the increase in osteopenia and osteoporosis seen in patients with Crohn's disease. OBJECTIVE: To determine the frequency of low serum 25-hydroxy-vitamin D3 (25-OHD) levels and the associated alterations in bone mineral density in a cohort of adults with Crohn's disease. METHODS: 25-OHD levels were determined in 242 consecutive patients with Crohn's disease seen in two tertiary inflammatory bowel disease referral centres. Bone mineral density was assessed by dual energy x-ray absorptiometry. RESULTS: Nineteen (8%) patients exhibited vitamin D deficiency (25-OHD less than 25 nmol/L) and 52 (22%) patients exhibited vitamin D insufficiency (25-OHD less than 40 nmol/L). Mean T-scores at the lumbar spine, femoral neck, total hip and ultradistal radius in the group with low 25-OHD did not differ from those of the normal 25-OHD group. Serum alkaline phosphatase and parathyroid hormone levels were higher in the low 25-OHD group than in the normal group. Decreased red blood cell (RBC) folate predicted low 25-OHD in male patients, while smoking, RBC folate and serum iron predicted low 25-OHD in female patients. The rate of low 25-OHD deficiency in the winter was significantly higher than that in the summer (11.9% versus 2.8%, respectively). CONCLUSION: Vitamin D-deficient Crohn's disease patients exhibit biochemical evidence of metabolic bone disease, without detectable differences in bone mineral density. Sunlight exposure, nutrition and smoking status were predictors of vitamin D deficiency in this patient cohort.