title: High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition.
abstract: BACKGROUND
  Previous studies have noticed the high incidence of suboptimal vitamin D (VtD) status and bone loss in short bowel syndrome (SBS) with parenteral nutrition (PN) dependence. However, limited data have focused on adult SBS without PN dependence. Therefore, our objective was to investigate the incidence and risk factors of suboptimal VtD status and bone loss in adult SBS even after weaning off PN.
  
  
  METHODS
  We performed a prospective study of 60 adult patients with SBS. Serum 25-hydroxyvitamin D (25-OHD) was measured by radioimmunoassay. Bone mineral density (BMD) was measured using dual-energy x-ray absorptiometry (DEXA). Medical records and various laboratory parameters were collected in all participants.
  
  
  RESULTS
  Suboptimal VtD status was identified in all individuals, including 3 (5.0%) with VtD insufficiency and 57 (95.0%) with VtD deficiency. Residual small bowel length (B, 0.072, P = .001) and duration of SBS (B, -0.066, P = .020) were both significantly correlated with suboptimal VtD levels. Overall, only 2 patients presented a normal BMD; osteopenia and osteoporosis were noted in 41 (68.3%) and 17 (28.3%) individuals, respectively. Low 25-OHD concentration was associated with a decreased BMD (B, 0.065, P = .029). There were no other demographic characteristics or clinical examinations associated with suboptimal VtD levels and bone loss.
  
  
  CONCLUSIONS
  Suboptimal VtD status and bone loss were common in adult SBS even after weaning off PN. Despite routine oral VtD supplementation, most patients did not achieve satisfactory status. This emphasizes the critical importance of routine surveillance of 25-OHD and BMD, as well as consideration of alternative methods of supplementation after weaning off PN.
authors: 1 Department of General Surgery, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Shengxian
authors: S
authors: Fan
authors: 2 Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Xiaodong
authors: X
authors: Ni
authors: 2 Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Jian
authors: J
authors: Wang
authors: 2 Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Yongliang
authors: Y
authors: Zhang
authors: 2 Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Shen
authors: S
authors: Tao
authors: 2 Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Wencheng
authors: W
authors: Kong
authors: 3 Department of General Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Yousheng
authors: Y
authors: Li
authors: 2 Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Jieshou
authors: J
authors: Li
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D001847:Bone Diseases / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012778:Short Bowel Syndrome / Q000097:blood* / Q000628:therapy; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology; D055815:Young Adult
chemical_list: D014807:Vitamin D
keywords: metabolic bone diseases; osteoporosis; parenteral nutrition; short bowel syndrome; vitamin D; vitamin D deficiency