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Are Vitamin D Levels Related to Sarcopenia in Children with Inflammatory Bowel Disease?
Sevim Çakar1, Gülin Eren2, Cahit Barış Erdur2
1Department of Pediatrics, Division of Pediatric Gastroenterology, Faculty of Medicine, Dokuz Eylül University, Izmir 35330, Turkey.
Insights
Pediatric inflammatory bowel disease (IBD) patients often have sarcopenia and vitamin D deficiency. Lower vitamin D levels correlate with more severe sarcopenia in children with Crohn
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Musculoskeletal Health
Background:
- Limited data exists on vitamin D deficiency's impact on sarcopenia in pediatric inflammatory bowel disease (IBD).
- This study investigates the relationship between vitamin D levels and sarcopenia in newly diagnosed pediatric IBD patients.
Purpose of the Study:
- To assess the prevalence of sarcopenia in pediatric IBD patients.
- To examine the association between vitamin D status and sarcopenia in this population.
Main Methods:
- Retrospective cross-sectional study of pediatric IBD patients diagnosed at a tertiary care hospital.
- Magnetic resonance (MR) enteroclysis used to measure total psoas muscle area (tPMA) at L4/L5.
- Sarcopenia defined as tPMA below the 10th percentile for age-matched healthy children; vitamin D deficiency defined as serum 25-OH-D < 20 ng/mL.
Main Results:
- High prevalence of sarcopenia observed: 85% in ulcerative colitis (UC) and 81% in Crohn's disease (CD) patients.
- Severe vitamin D deficiency was prevalent: 35.9% in UC and 38.5% in CD.
- Vitamin D levels were significantly lower in patients with the most severe sarcopenia (below 3rd percentile tPMA).
Conclusions:
- Sarcopenia is highly prevalent in newly diagnosed pediatric IBD patients.
- Vitamin D deficiency is common and associated with more severe sarcopenia.
- Strategies for preventing and treating vitamin D deficiency may benefit IBD patients by mitigating sarcopenia.
Abstract:
Background: Data on the impacts of vitamin D deficiency on sarcopenia in pediatric patients with inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are lacking. We aimed to investigate the relationships between vitamin D levels and sarcopenia in patients with newly diagnosed IBD. Methods: A cross-sectional, retrospective study was conducted in a tertiary care children's hospital. Pediatric IBD patients who underwent magnetic resonance (MR) enteroclysis at the time of initial diagnosis were included. Total psoas muscle area (tPMA) at the L4/L5 intervertebral level was demonstrated on MR by scanning the right and left psoas muscle areas. Sarcopenia was defined as a measurement under the 10th percentile according to MR-derived reference values of tPMA percentile charts for healthy children aged 1-18 years. Vitamin D insufficiency was defined as a serum 25-OH-D level below 30 ng/mL and deficiency as that below 20 ng/mL. Collected data from demographic evaluation, clinic, and laboratory tests were statistically assessed. Results: According to the MR-derived reference values of tPMA, 85% (n = 33) of UC and 81% (n = 21) of CD patients had sarcopenia. The severe vitamin D deficiency ratio was 35.9% (n = 14) in UC and 38.5% (n = 10) in CD. We found that vitamin D levels were similar in patients with UC and CD, while they were significantly lower in the group below the 3rd percentile of tPMA (n = 41, median 9.8) than in the group between the 3rd and 10th percentiles (n = 13, median 16.9; p = 0.038). Conclusions: Formulating strategies to recognize and prevent sarcopenia, including the prevention and-if necessary-the treatment of vitamin D deficiency, could bring multi-faceted benefits.
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