25-hydroxyvitamin D absorption in patients with Crohn's disease and with pancreatic insufficiency.
Vitamin D malabsorption could be one possible reason for the high prevalence of vitamin D deficiency and osteopenia in patients with Crohn's disease (CD) and pancreatic insufficiency (PI). Hence, we performed a modified 25-hydroxyvitamin D (25-OHD) absorption test Stamp in 15 healthy controls, 31 patients with CD and 10 patients with PI. Serum 25-OHD levels were measured before, and 2, 4, 8, and 24 hours after oral administration of 5 micrograms 25-OHD/kg body weight. Basal 25-OHD levels were below the normal range of 12-36 ng/ml in 68% of patients with CD (median: 10; interquartile range: 4-12 ng/ml) and 70% of patients with PI (median: 3; interquartile range: 2-14 ng/ml). Peak levels were reached at 4 or 8 hours after ingestion of 25-OHD. Three patients with CD (10%) and 5 patients with PI (50%) showed decreased 25-OHD absorption. 25-OHD levels normalized in all but two patients with PI after 24 hours. Pattern of involvement or previous resections did not show a significant influence on 25-OHD absorption. Vitamin D malabsorption may be one reason for vitamin D deficiency in many patients with PI, but there is little evidence of vitamin D malabsorption in patients with CD. Oral 25-OHD administration seems to be a useful therapeutic alternative to native vitamin D in patients with possible malabsorption and vitamin D deficiency.
Vogelsang
H
H
Klinische Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik für Innere Medizin IV, Vienna, Austria.
Schöfl
R
R
Tillinger
W
W
Ferenci
P
P
Gangl
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003424:Crohn Disease / Q000097:blood*; D010188:Exocrine Pancreatic Insufficiency / Q000097:blood*; D005260:Female; D006801:Humans; D007408:Intestinal Absorption / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood
D014807:Vitamin D; C104450:25-hydroxyvitamin D