Osteomalacia in Crohn’s disease

Dedeoglu, Meryem; Garip, Yeşim; Bodur, Hatice

doi:10.1007/s11657-014-0177-0

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…Adequate calcium intake is crucial due to IBD’s association with an increased incidence of osteoporosis, and additionally, during ongoing inflammation, pro-inflammatory cytokines affect the activity of bone cells [ 42 ]. Due to impaired vitamin D absorption being associated with the disease, osteomalacia, which is associated with impaired bone mineralization, may also occur [ 48 ]. Studies by other researchers have also observed lower dietary calcium intake in patients with IBD [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

Differences in Dietary Patterns of Adolescent Patients with IBD

et al. 2021

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Inflammatory bowel disease (IBD) includes Crohn’s disease (CD) and ulcerative colitis (UC). The prevalence of both in pediatric populations has been constantly increasing. This study aimed to analyze the diet of adolescent patients with IBD in comparison to healthy controls and the current dietary standards for the Polish population to further their optimal supplementation regimen. The study group consisted of 53 patients (21 girls and 32 boys) with IBD (CD: n = 27; UC: n = 26) at a mean age of 15.4 ± 2.4 and 14.7 ± 2.2, years for girls and boys, respectively. The control group (CG) consisted of 20 patients, and 72 h of recall diaries on nutrition were collected. The nutritional data were analyzed in the Dieta 6D dietary program. When compared to Polish dietary standards, the largest differences girls with IBD and boys with IBD were found for the intake of energy (61.9 and 71.9%), iodine (61.9 and 62.6%), folates (76.2 and 87.5%), vitamin D (100 and 96.9%), potassium (61.9 and 59.4%), and calcium (85.7 and 93.8%). The overconsumption of saturated fatty acids (SFA) (61.9 and 56.3%) and sodium (76.2 and 90.6%) in girls and boys, respectively, was noted. In relation to girls with CG, girls with IBD showed a significantly higher intake of energy (1751. 3 vs. 1558.6 p = 0.0224), total protein (71.3 vs. 56.2 p = 0.0217), animal protein (47.8 vs. 34.5 p = 0.0183), total carbohydrates (237.3 vs. 196.1 p = 0.0442), and assimilable carbohydrates (219.8 vs. 180.5 p = 0.7921). Boys in the CG consumed significantly more calcium (851.8 vs. 432 p = 0.0006), phosphorus (1024.3 vs. 1357.5 p = 0.0431), lactose (11.6 vs. 6.1 p = 0.0016), and riboflavin (1.7 vs. 1.3 p = 0.0123) compared to boys with IBD. Dietician care should therefore be mandatorily provided alongside outpatient care. Based on our results, we suggest that supplementation with the selected components be considered.

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Section: Discussionmentioning

confidence: 99%

Differences in Dietary Patterns of Adolescent Patients with IBD

et al. 2021

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“…In a pre-clinical study, mice with the absence of endothelial VDR expression displayed reduced bioavailability of NO due to impaired expression of the NO synthesizing enzyme, eNOS, within the endothelium (2). Similarly, when the endothelial-specific VDR was knocked out, reduction in eNOS expression and impaired ACh-induced vasorelaxation were observed in the aorta of mice [5].…”

Section: Effect Of Vitamin D On Regulation Of Nitric Oxide (No) Bioavmentioning

confidence: 99%

“…Data from the 2005-2006 National Health and Nutrition Examination Survey indicate that vitamin D deficiency, defined as a serum 25-hydroxyvitamin D levels ≤ 20 ng/mL (50 nmol/L), is common among adults aged 20 years and over in the United States (US), with 41.6% of adults reporting a vitamin D deficiency [1]. This vitamin D deficiency epidemic can be attributable to factors such as poor sunlight exposure, insufficient intake of vitamin-containing foods and malabsorption syndromes such as Crohn's disease and celiac disease [2].…”

Section: Introductionmentioning

confidence: 99%

Vitamin D and Endothelial Function

et al. 2020

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Vitamin D is known to elicit a vasoprotective effect, while vitamin D deficiency is a risk factor for endothelial dysfunction (ED). ED is characterized by reduced bioavailability of a potent endothelium-dependent vasodilator, nitric oxide (NO), and is an early event in the development of atherosclerosis. In endothelial cells, vitamin D regulates NO synthesis by mediating the activity of the endothelial NO synthase (eNOS). Under pathogenic conditions, the oxidative stress caused by excessive production of reactive oxygen species (ROS) facilitates NO degradation and suppresses NO synthesis, consequently reducing NO bioavailability. Vitamin D, however, counteracts the activity of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase which produces ROS, and improves antioxidant capacity by enhancing the activity of antioxidative enzymes such as superoxide dismutase. In addition to ROS, proinflammatory mediators such as TNF-α and IL-6 are risk factors for ED, restraining NO and eNOS bioactivity and upregulating the expression of various atherosclerotic factors through the NF-κB pathway. These proinflammatory activities are inhibited by vitamin D by suppressing NF-κB signaling and production of proinflammatory cytokines. In this review, we discuss the diverse activities of vitamin D in regulating NO bioavailability and endothelial function.

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“…Alternative sources of vitamin D3 include animal products, such as fatty fish, while vitamin D2 (ergocalciferol) can be obtained mainly from dietary plant and fungal sources such as mushrooms. Consequently, major risk factors for vitamin D deficiency include inadequate sunlight exposure, inadequate dietary intake of vitamin D-containing foods, and malabsorption syndromes such as Crohn’s disease and celiac disease [ 2 ]. Although clinically apparent manifestations of vitamin D deficiency, such as rickets in children or periosteal bone pain in adults, are uncommon in most developed countries, recent literature suggests that subclinical, asymptomatic vitamin D deficiency still plays a notable role in contributing to several of the leading causes of death, including cardiovascular disease, cancer, and diabetes.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012)

Parva¹,

Tadepalli²,

Singh³

et al. 2018

Cureus

139

107

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Introduction1,25-dihydroxyvitamin D3 (cholecalciferol), the hormonally active form of vitamin D3, is a lipid-soluble compound that plays a significant role in clinical medicine due to its potent effects on calcium homeostasis and bone metabolism. Since foods containing natural vitamin D are rare, the primary source of the compound remains its nonenzymatic dermal synthesis through exposure to ultraviolet rays in sunlight. Although uncommon in most developed countries, recent literature has demonstrated that subclinical vitamin D deficiency can exist in certain populations and plays a role in downstream clinical consequences, including cardiovascular disease, cancer, diabetes, osteoporosis, and fractures. This study aims to identify the prevalence and change in the pattern of vitamin D deficiency in subpopulations throughout the United States to provide a foundation for further clinical studies correlating the clinical outcomes to vitamin deficiency.MethodsData analyzed in this study were collected through National Health and Nutrition Examination Survey (NHANES), specifically from a population of 4962 participants, age ≥20 years, who were hospitalized between 2011 and 2012. This cohort was stratified to divide the population into patients that were vitamin D sufficient (>50 nmol/L) versus patients who were vitamin D deficient (50 nmol/L). The risk factors were compared between the subpopulations in 2005-2006 and 2011-2012.ConclusionsThe prevalence of vitamin D deficiency is greater in certain clinical subpopulations, and the presence of associated characteristics should raise the index of suspicion for the practicing clinician with regard to conditions associated with vitamin D deficiency, such as osteoporosis and osteomalacia. Further research investigating the pathophysiology of hypovitaminosis D and its clinical consequences can help better understand and prevent the development of associated comorbidities.

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Osteomalacia in Crohn’s disease

Abstract: Osteomalacia should be considered in differential diagnosis when assessing low back pain in the patients with chronic inflammatory bowel disease. Vitamin D deficiency should be treated with vitamin D supplementation in patients with Crohn's disease to prevent osteomalacia.

Cited by 13 publications

References 10 publications

Differences in Dietary Patterns of Adolescent Patients with IBD

Differences in Dietary Patterns of Adolescent Patients with IBD

Vitamin D and Endothelial Function

Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012)

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