Seasonal variability of vitamin D deficiency in patients with inflammatory bowel disease and other chronic diseases
Authors:
P. Horváthová 1*; K. Frivolt 1*; K. Prochotská 1; E. Vitáriušová 1; T. Kyselová 2; J. Šemberová 2; Z. Pribilincová 1; I. Čierna 1; T. Dallos 1; L. Kovács 1
Authors‘ workplace:
Detská klinika Lekárskej fakulty Univerzity Komenského a Detskej fakultnej nemocnice
s poliklinikou, Bratislava
1; Pracovisko klinickej imunológie a alergológie Detskej fakultnej nemocnice s poliklinikou, Bratislava
2
Published in:
Čes-slov Pediat 2017; 72 (4): 232-238.
Category:
Original Papers
*Autori prispeli k tejto práci rovnakým dielom
Overview
Background:
Bone remodelling is regulated by hormones and paracrine factors. Vitamin D deficiency is often present in patients with chronic disease, but also among healthy children.
Aims:
To investigate vitamin D deficiency and other markers of bone metabolism among Slovak out-patients and hospitalized children.
Methods:
In this prospective single center study serum levels of vitamin 25-OH-D3 and bone markers were investigated in spring (march-may) and/or in autumn (september – november) in children aged 6–18 years.
Results:
We enrolled 199 children, in 70 we performed two examinations in spring and in autumn. Serum level of vitamin D in the entire cohort was 22.5±9.3 ng/ml with a significant seasonal variability (20.4±9.1 ng/ml in spring vs. 25.7±8.9 ng/ml in autumn, p<0.0001) that was present in both the control group (n=84) and in children with chronic disease (n=72), except children with inflammatory bowel disease (n=43). Overall, vitamin D deficiency was present in 20.0% of cases, in spring in 27.3% and in autumn in 9.3%. Parathyroid hormone was elevated in 57.1% of patients with vitamin D deficiency and correlated negatively with vitamin D levels (r=-0.541, p=0.001). In adolescent children, vitamin D level correlated positively with osteoprotegerin level (r=0.362, p=0.036) and the OPG/RANKL ratio (r=0.524, p=0.001) and negatively with RANKL level (r=-0.524, p=0.001).
Conclusion:
We found a high prevalence of insufficient vitamin D levels that was associated with increased parathyroid hormone and in adolescents with increased RANKL level with potentially negative impact on bone health. It is important to draw parents´attention to the importance of vitamin D supplementation, particularly in winter, in both, children with chronic diseases as well as healthy ones.
Key words:
children, bone metabolism, chronic diseases, Crohn’s disease, ulcerative colitis, inflammatory bowel disease, vitamin D, parathyroid hormone, osteoprotegerin, RANKL
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2017 Issue 4
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