Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Kotze, Lorete Maria da Silva; Costa, Carolina Tabata; Cavassani, Murilo Franco; Nisihara, Renato

doi:10.1590/1806-9282.63.01.13

Cited by 13 publications

(13 citation statements)

References 17 publications

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“…The level of 25(OH)D was within the lower limit of the normal range among the studied children with CD. In other studies, similar results are observed and in some cases serum levels are even lower [27,36,37]. The morphological parameters of the blood were mostly normal, with the exception of low hemoglobin and hematocrit, and elevated monocyte counts in girls.…”

Section: Discussionsupporting

confidence: 82%

Quantitative assessment of nutrition and nutritional status of patients with Crohn’s disease aged 13–18

Konecka

Kikut

2020

Pomeranian Journal of Life Sciences

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Introduction: Crohn’s disease (CD) is classified as an inflammatory bowel disease, with a recent increased incidence in developed countries. Treatment is based on pharmacotherapy and nutritional support. Patients in the exacerbation phase are particularly exposed to the development of malnutrition, which in the case of children may result in the inhibition of growth or delay in puberty. For these reasons, nutrition is very important in the treatment process. In the remission phase of the disease, the diet should be consistent with the recommendations for the population of healthy people in order to prevent the formation of vitamin and mineral deficiencies.The aim of the study was to determine the nutritional status of adolescent CD patients and to analyze their diet.Materials and methods: The study was conducted on 14 children with CD, 6 girls and 8 boys with an average age of 16.25 ±1.65 years. Their nutrition was analyzed based on information obtained from a nutritional history collected over 3 days. The collected information was entered into the Diet 5 software. The results of the menus were compared to current dietary norms. The nutritional status of the children was based on a body mass index (BMI) analysis with reference to OLA and OLAF percentiles. The additional results of morphology and the levels of sodium, potassium, total calcium and 25(OH)D from their blood were compared. All obtained results were analysed statistically using Statistica v12.0 software.Results: The nutritional status of both the boys and the girls was normal, however the energy consumption was low (2274.83 ±475.93 kcal and 1843.33 ±258.4 kcal). Protein consumption was high, at 86.44 ±29.57 g and 62.36 ±26.51 g. In both groups, the levels of saturated fatty acids were too high (30.38 ±14.45, 23.02 ±13.53 mg), and in the boys’ group cholesterol was too high (427.41 ±278.3 mg). Both sexes consumed insufficient amounts of fiber (17.32 ±7.63 g, 19.84 ±4.85 g) and omega-3 (1.8 ±0.99 g, 1.74 ±0.89 g). Iron, copper, iodine and zinc were consumed at the appropriate level. Both sexes consumed too little calcium (586.44 ±458.11 mg, 742.47 ±515.37 mg), potassium (2892.96 ±1223.79 mg, 2901.62 ±1028.56 mg) and magnesium (283.45 ±145.26 mg, 276.71 ±163.32 mg). Folate consumption was too low (256.44 ±81.02 μg, 231.07 ±81.03 μg), vitamin D (2.85 ±1.00 μg, 0.96 ±0.68 μg) and also vitamin E in the group of girls (7.02 mg ±1.46 mg). The blood parameters did not differ significantly between the sexes, and the concentration of 25(OH)D was within the lower limit of the norm (28.17 ±5.91 ng/dL, 22.60 ±3.38 ng/dL).Conclusions: Low energy intake may adversely affect the nutritional status of CD patients. A deficiency in the diet of n-3 acids may promote the development of inflammation. Insufficient intake of calcium and vitamin D can disrupt the development of the skeletal system. The insufficient intake of dietary fiber can lead to constipation. A too low vitamin D intake and low blood levels of its metabolite indicate the need for supplementation. Additional supplementation of potassium and magnesium should be taken into consideration in the nutrition of CD patients.

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Section: Discussionsupporting

confidence: 82%

Quantitative assessment of nutrition and nutritional status of patients with Crohn’s disease aged 13–18

Konecka

Kikut

2020

Pomeranian Journal of Life Sciences

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“…This could underestimate the true weight that the latter may have as predictors of vitamin D deficiency. On the other hand, this is one of the few studies on the subject performed in a South American setting, apart from a recently published study by Kotze et al (18) .…”

Section: Discussionmentioning

confidence: 93%

Vitamin D Deficiency Among Inflammatorybowel Disease Patients in Argentina: A Cross-Sectional Study

Torella

Rausch

Lasa

et al. 2018

Arq. Gastroenterol.

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BACKGROUND: An association has been established between low serum values of vitamin D and inflammatory bowel disease. There is a lack of evidence on whether this association is still observed in regions where sun exposure throughout the year is higher. OBJECTIVE: To compare the prevalence of vitamin D deficiency between inflammatory bowel disease patients and healthy controls. METHODS: Inflammatory bowel disease patients were consecutively enrolled as cases. Age and gender-matched healthy subjects who agreed to undertake a determination of serum vitamin D were enrolled as controls. Demographic features, medical treatment, need for hospital admission at diagnosis, steroid treatment, smoking, need for surgical treatment were evaluated as factors associated with vitamin D deficiency. RESULTS: Overall, 59 patients with a diagnosis of either Crohn’s disease or ulcerative colitis were enrolled, as well as 56 controls. Median age was 41 years (19-79) and 56% were male. Vitamin D deficiency was observed in 66.1% of inflammatory bowel disease patients versus 21.42% of healthy controls (OR 7.15 (3.1-16.48), P=0.001). Among inflammatory bowel disease patients, male gender, disease duration, moderate-to-severe disease and hospital admission at the moment of diagnosis were found to be associated with vitamin D deficiency. On multivariate analysis, only longer disease duration [(OR 1.01 (1-1.06)] and hospital admission at diagnosis [(OR 5.63 (1.01-31.61)] were found to be significantly associated with the latter. CONCLUSION: Vitamin D deficiency was more frequent among inflammatory bowel disease patients. Longer disease duration and need for hospital admission at diagnosis were associated to vitamin D deficiency among these patients.

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“…Osteoporosis is typically a multifactorial disease. The pathogenic mechanisms that might contribute to low BMD in IBD patients include advancing age, low BMI, smoking, alcohol abuse, immobilization or inactive lifestyle, the activation of inflammatory cytokines, hypogonadism, malnutrition, intestinal malabsorption of calcium and vitamin D, the use of corticosteroids, and genetic susceptibility [4,33].…”

Section: Discussionmentioning

confidence: 99%

“…There is a growing body of evidence that patients with Inflammatory Bowel Disease (IBD) are at increased risk for osteopenia and osteoporosis. Osteopenia and osteoporosis are common extraintestinal complications in IBD that increase the Several studies have demonstrated a decrease in Bone Mineral Density (BMD) in patients with Crohn's Disease (CD), and to a less extent in Ulcerative Colitis (UC) [4]. The higher prevalence of bone disease in CD patients is thought to be related to ileal and small intestine involvement of diseasecausing vitamin D and calcium malabsorption, estrogen deficiency and malnutrition [1,5].…”

Section: Introductionmentioning

confidence: 99%

Bone Mineral Density and Bone Remodeling in Tunisian Patients with Inflammatory Bowel Disease

Jemaa¹,

Chtourou²,

Akrout³

et al. 2019

TORJ

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Background:A high prevalence of osteopenia and osteoporosis is observed in patients with Inflammatory Bowel Disease (IBD).Objective:The aim of our study was to investigate the prevalence of bone loss, bone remodeling and risk factors in Tunisian patient with IBD.Patients and Methods:The study included 40 patients with IBD and 32 age- and sex-matched healthy controls subjects. All participants underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine. Serum levels of 25-hydroxy vitamin D (25(OH)D), parathyroid hormone (PTH), osteocalcin(OC), and urinary degradation products of C-terminal telopeptide of type I collagen (CTXI) were measured in all participants to assess the bone metabolism status.Results:Twelve (30%) patients were normal, 32.5% were osteopenic and 37.5% were osteoporotic. Osteoporosis was more frequent in IBD patients than controls (p=0.0001). Age and inflammation were associated with low bone mineral density (BMD). Mean calcium, phosphorus and alkaline phosphatase levels were similar in both groups. Median 25(OH) D levels were significantly lower in IBD patients compared with controls (p=0.0001). Median urinary CTXI levels were significantly higher in IBD patients compared with healthy controls (p=0.007). No significant differences between IBD patients and controls concerning the median serum OC and PTH levels were found.Conclusion:In our study, there is a high prevalence of low BMD in IBD patients and an increase in bone resorption without a change of bone formation. Low BMI and hypovitaminoses D were identified as risk factors for low BMD.

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Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Cited by 13 publications

References 17 publications

Quantitative assessment of nutrition and nutritional status of patients with Crohn’s disease aged 13–18

Quantitative assessment of nutrition and nutritional status of patients with Crohn’s disease aged 13–18

Vitamin D Deficiency Among Inflammatorybowel Disease Patients in Argentina: A Cross-Sectional Study

Bone Mineral Density and Bone Remodeling in Tunisian Patients with Inflammatory Bowel Disease

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