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Vitamin D Status and Bone Mineral Density in Children with Inflammatory Bowel Disease Compared to Those with
Jenny Sohn1,2, Eun Jae Chang2, Hye Ran Yang2,3
1Melbourne Medical School, Univeristy of Melbourne, Melbourne, Australia.
Insights
Vitamin D levels do not significantly impact bone mineral density (BMD) in children with inflammatory bowel disease (IBD). Female sex, older age, and low hemoglobin are key risk factors for reduced BMD in pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Endocrinology
- Bone Metabolism
Background:
- Low vitamin D is linked to reduced bone mineral density (BMD) in pediatric inflammatory bowel disease (IBD).
- Understanding vitamin D's role in pediatric IBD bone health is crucial for effective management.
Purpose of the Study:
- To compare serum 25-hydroxyvitamin D (25[OH]D) and total body less head (TBLH) BMD z-scores in children with Crohn's disease (CD), ulcerative colitis (UC), and functional gastrointestinal disorders (AP-FGID).
- To investigate the correlation between 25[OH]D and TBLH BMD z-scores, and identify associated factors in these pediatric groups.
Main Methods:
- Cross-sectional study including 105 children divided into AP-FGID (n=45), CD (n=43), and UC (n=17) groups.
- Serum 25(OH)D levels and TBLH BMD z-scores were measured and analyzed.
- Statistical analysis identified factors influencing BMD z-scores and 25(OH)D levels.
Main Results:
- Significant differences in TBLH BMD z-scores were observed among the groups (CD: 0.5 ± 0.8, UC: 0.1 ± 0.8, AP-FGID: -0.1 ± 1.1; P=0.037), despite similar 25(OH)D levels.
- No significant correlation was found between serum 25(OH)D and TBLH BMD z-score within each group.
- Factors affecting TBLH BMD z-score included female sex, older age, and lower serum hemoglobin. Factors influencing 25(OH)D included female sex, CD diagnosis, and serum phosphorus.
Conclusions:
- Vitamin D appears to be a minor factor in bone loss among children with IBD.
- Clinicians should prioritize assessing female sex, older age, and low hemoglobin as risk factors for reduced BMD in pediatric IBD.
- Further research may explore multifactorial approaches to bone health in pediatric IBD.
Abstract:
Low vitamin D has been implicated in reduced bone mineral density (BMD) in children with inflammatory bowel disease (IBD). Our study aimed to evaluate differences in serum 25-hydroxyvitamin D (25[OH]D) and total body less head (TBLH) BMD z-scores in children with Crohn's disease (CD), ulcerative colitis (UC), and those with abdominal pain-related functional gastrointestinal disorder (AP-FGID) as the control group. We also examined the correlation between serum 25(OH)D and TBLH BMD z-score, and factors that affect each of these parameters. A total of 105 children were included and divided into 3 groups: AP-FGID (n = 45), CD (n = 43), and UC (n = 17). Among the 3 study groups, TBLH BMD z-scores were found to be significantly different (0.5 ± 0.8 in CD vs. 0.1 ± 0.8 in UC vs. -0.1 ± 1.1 in FGID; P = 0.037), despite similar levels of serum 25(OH)D. Within each study group, correlation between serum 25(OH)D and TBLH BMD z-score was not observed. Factors found to affect the TBLH BMD z-score were sex (P = 0.018), age (P = 0.005) and serum hemoglobin (P = 0.041), while factors influencing serum 25(OH)D were sex (P = 0.018), CD with reference to AP-FGID (P = 0.020), and serum phosphorus (P = 0.018). Based on our results, vitamin D is a relatively small contributor to bone loss in pediatric IBD and clinicians should consider female sex, older age, and low hemoglobin as risk factors for low BMD in children with IBD.
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