title: Vitamin D deficiency and low bone mineral density in pediatric and young adult intestinal failure.
abstract: OBJECTIVE
  The aim of the present study was to determine the prevalence and predisposing factors for vitamin D deficiency and low bone mineral density (BMD) in patients with intestinal failure (IF).
  
  
  METHODS
  A retrospective review of patients with IF managed at the Cincinnati Children's Hospital Medical Center. IF was defined as history of parenteral nutrition (PN) >30 days. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25 (OH) D) <20 ng/dL. Reduced BMD was defined using dual x-ray absorptiometry z score ≤-2. A binary logistic regression model was used to test for association of significant risk factors and the outcome variables after univariate analyses.
  
  
  RESULTS
  One hundred and twenty-three patients with median age of 4 years (range 3-22 years) were evaluated. Forty-nine (39.8%) patients had at least a documented serum 25 (OH) D deficiency during the study interval, whereas 10 of 80 patients (12.5%) with dual x-ray absorptiometry scans completed had a low BMD z score. Age at study entry was associated with both 25 (OH) D deficiency (P = 0.01) and low BMD z score (P = 0.03). Exclusive PN at study entry was associated with reduced bone mass (P = 0.03). There was no significant association between vitamin D deficiency and low BMD z score (P = 0.31).
  
  
  CONCLUSIONS
  The risk of 25 (OH) D deficiency and low BMD z score increases with age among patients with IF. Strategies for monitoring and preventing abnormal bone health in older children receiving exclusive PN need to be developed and evaluated.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children Hospital Medical Center, Cincinnati, OH, USA. zionagoz@yahoo.co.uk
authors.forename: Agozie C
authors.initials: AC
authors.lastname: Ubesie
authors.forename: James E
authors.initials: JE
authors.lastname: Heubi
authors.forename: Samuel A
authors.initials: SA
authors.lastname: Kocoshis
authors.forename: Carol J
authors.initials: CJ
authors.lastname: Henderson
authors.forename: Adam G
authors.initials: AG
authors.lastname: Mezoff
authors.forename: Marepalli B
authors.initials: MB
authors.lastname: Rao
authors.forename: Conrad R
authors.initials: CR
authors.lastname: Cole
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D015519:Bone Density; D001847:Bone Diseases / Q000097:blood / Q000209:etiology* / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications*; D016015:Logistic Models; D008286:Malabsorption Syndromes / Q000209:etiology; D008297:Male; D009820:Ohio; D010289:Parenteral Nutrition, Total / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000209:etiology*; D055815:Young Adult
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D