title: Vitamin D deficiency in patients receiving home parenteral nutrition.
abstract: BACKGROUND
  In addition to its role in bone metabolism, vitamin D has important immunomodulatory and antineoplastic effects. Patients on home parenteral nutrition (HPN) receive most of their vitamin D from intravenous (IV) supplementation. Vitamin D deficiency is common in the general population, and the adequacy of vitamin D supplementation in HPN patients is unclear. The purpose of this study is to determine the vitamin D status of patients on HPN.
  
  
  METHODS
  Consecutive patients seen in a regional home nutrition program had their oral and IV vitamin D intakes determined. Plasma 25-hydroxyvitamin D levels were measured in all patients. Intake of calcium, magnesium, and phosphate were also determined.
  
  
  RESULTS
  The mean 25-hydroxyvitamin D level in 22 patients receiving HPN for a mean of 33.5 months (range, 1-177) was 42 nmol/L. Vitamin D deficiency was present in 15 (68%) patients and vitamin D insufficiency in 6 (27%) patients. The mean dietary vitamin D intake was 79.5 IU per day, while the mean IV supplementation was 166 IU per day.
  
  
  CONCLUSIONS
  In this study of a regional Canadian HPN program, there was a high prevalence of vitamin D deficiency/insufficiency affecting virtually all patients. All patients receiving HPN should be supplemented with vitamin D and have their 25-hydroxyvitamin D levels monitored. Further studies are required to determine optimal methods and dosing of vitamin D replacement using oral supplements or ultraviolet light therapy.
authors.affiliation: Department of Medicine, Division of Gastroenterology, C5120 409 Tache Ave, St Boniface Hospital, Winnipeg, Manitoba, Canada. duerksn@cc.umanitoba.ca
authors.forename: Patti
authors.initials: P
authors.lastname: Thomson
authors.forename: Donald R
authors.initials: DR
authors.lastname: Duerksen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002136:Calcium, Dietary / Q000008:administration & dosage; D002170:Canada; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects* / Q000379:methods; D015995:Prevalence; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology*; D014815:Vitamins / Q000097:blood; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D