Risk factors for vitamin D deficiency in patients with Crohn's disease.
BACKGROUND
Although the pathogenesis of osteopenia in Crohn's disease is not established, vitamin D deficiency is thought to be an important risk factor. However, little is known about the prevalence of vitamin D deficiency in patients with Crohn's disease in Japan. This study aimed to clarify the prevalence of vitamin D deficiency in patients with Crohn's disease in Japan and to examine the possible causes of the deficiency.


METHODS
We investigated serum 25-hydroxyvitamin D (25-OHD) levels, various laboratory parameters, and patient histories in 33 outpatients (25 men, 8 women; median age, 37 years; range, 26-57 years) and 15 age- and sex-matched healthy controls (8 men, 7 women; median age, 37 years; range, 24-57 years) and assessed risk factors for vitamin D deficiency.


RESULTS
Although patients with Crohn's disease did not have significantly lower serum concentrations of 25-OHD than controls, 9 of 33 patients (27.3%) were considered vitamin D deficient (serum 25-OHD level </=10 ng/ml) compared with only 1 of 15 (6.7%) controls. Serum 25-OHD levels were significantly related to disease duration ( r = 0.46, P = 0.003), Crohn's Disease Activity Index (CDAI) score ( r = 0.44, P = 0.005), International Organization for the Study of Inflammatory Bowel Disease score ( r = 0.30, P < 0.05), and serum values of ferritin ( r = 0.34, P = 0.03), C-reactive protein ( r = 0.34, P = 0.03), total cholesterol ( r = 0.31, P = 0.04), and intact parathyroid hormone ( r = 0.23, P < 0.05). A logistic regression analysis was performed to investigate the ability of variables to predict low or normal 25-OHD values. Results showed that disease duration ( P = 0.03) and CDAI score ( P = 0.04) could predict the occurrence of vitamin D deficiency ( r(2) = 0.472, P = 0.0004).


CONCLUSIONS
Vitamin D deficiency exists in patients with Crohn's disease in Japan. 25-OHD levels should be assessed in patients who have had Crohn's disease for a long time (>15 years) and who have been in the active stage of the disease for long periods.
Tajika
Masahiro
M
Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, 464-8681, Nagoya, Japan.
Matsuura
Akira
A
Nakamura
Tsuneya
T
Suzuki
Takashi
T
Sawaki
Akira
A
Kato
Tetsuya
T
Hara
Kazuo
K
Ookubo
Kenji
K
Yamao
Kenji
K
Kato
Masahiko
M
Muto
Yasutoshi
Y
D000328:Adult; D003092:Colitis / Q000097:blood / Q000453:epidemiology; D015897:Comorbidity; D003424:Crohn Disease / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007079:Ileitis / Q000097:blood / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology*
D014807:Vitamin D; D005293:Ferritins; C104450:25-hydroxyvitamin D