Related Experiment Video
Updated: Apr 11, 2026
DNBS/TNBS Colitis Models: Providing Insights Into Inflammatory Bowel Disease and Effects of Dietary Fat
Published on: February 27, 2014
The nondietary determinants of vitamin D status in pediatric inflammatory bowel disease
Lauren E Veit1, Louise Maranda2, Benjamin Udoka Nwosu1
1Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA.
Insights
Inflammatory bowel disease (IBD) patients show higher vitamin D deficiency, linked primarily to intestinal inflammation rather than albumin loss. Seasons and skin color influence vitamin D levels, but not weight or liver inflammation.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Immunology
Background:
- Vitamin D plays a crucial role in immune function and gut health.
- Inflammatory bowel disease (IBD) is associated with various nutritional deficiencies.
- Understanding vitamin D status in IBD is essential for managing the condition.
Purpose of the Study:
- To investigate the relationship between 25-hydroxy vitamin D (25[OH]D) levels and markers of vitamin D status in pediatric patients with IBD.
- To identify factors influencing vitamin D status in IBD, including intestinal inflammation, protein-losing enteropathy, hepatic dysfunction, adiposity, seasons, and skin pigmentation.
Main Methods:
- A retrospective case-control study comparing 59 pediatric IBD patients with 116 controls.
- Assessment of 25-hydroxy vitamin D (25[OH]D) levels, albumin, alanine transaminase (ALT), erythrocyte sedimentation rate (ESR), and body mass index (BMI).
- Analysis of associations between 25(OH)D and clinical markers, considering seasons and skin pigmentation.
Main Results:
- IBD patients exhibited a higher prevalence of vitamin D deficiency (42.4% vs. 26.7%) and elevated ALT (16.9% vs. 2.6%) compared to controls.
- 25(OH)D levels were highest in summer and lowest in winter, and higher in white individuals.
- Erythrocyte sedimentation rate (ESR), a marker of intestinal inflammation, was significantly associated with lower 25(OH)D levels in IBD patients (P = 0.010).
Conclusions:
- Intestinal inflammation is the primary determinant of vitamin D status in IBD, outweighing albumin-bound vitamin D loss.
- Extraintestinal factors like seasons and skin pigmentation significantly impact vitamin D levels in IBD.
- Adiposity and hepatic inflammation were not found to be significant determinants of vitamin D status in this cohort.
Objectives:
The aim of this study was to investigate the relationships between 25-hydroxy vitamin D (25[OH]D) and markers of vitamin D status in inflammatory bowel disease (IBD).
Methods:
We conducted a retrospective case-control study of 59 pediatric patients with IBD (age 16.4 ± 2.2 y) and 116 controls (age 14.6 ± 4.4 y), to investigate the association between 25(OH)D and albuminemia for protein-losing enteropathy (PLE) and hepatic dysfunction; alanine transaminase (ALT) for hepatic inflammation; erythrocyte sedimentation rate (ESR) for intestinal inflammation; body mass index (BMI) for adiposity; seasons and skin pigmentation for insolation. Vitamin D deficiency was defined as 25(OH)D < 50 nmol/L; abnormal liver enzyme by ALT >40 U/L; overweight status by BMI of ≥85th but <95th percentile, and obesity by BMI ≥95th percentile. Seasons were categorized as summer, winter, spring, and fall.
Results:
Patients with IBD had a higher prevalence of vitamin D deficiency (42.4% versus 26.7%; P = 0.04), elevated ALT (16.9% versus 2.6%; P < 0.001), and lower albumin (41.1 ± 4.8 versus 45.1 ± 3.8; P < 0.001) than controls. In both the IBD cohort and controls, 25(OH)D was highest in summer and lowest in winter, and significantly higher in white than in non-white patients. ESR varied significantly with 25(OH)D (R(2) = 0.24; β = -0.32; P = 0.010), and only patients with IBD with elevated ESR had lower 25(OH)D than controls (49.5 ± 25.2 versus 65.3 ± 28.0 nmol/L; P = 0.045).
Conclusion:
Intestinal inflammation, not the loss of albumin-bound vitamin D in the gut, is the primary intestinal determinant of vitamin D status in IBD. The extraintestinal determinants are seasons and skin pigmentation, but not adiposity and hepatic inflammation.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:23Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
01:29Inflammatory Bowel Disease IV: Pharmacological Management
Pharmacologic...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...