title: Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease.
abstract: BACKGROUND
  Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are characterized by chronic inflammation of the intestine that can reduce the absorption of nutrients such as vitamin D and calcium.
  
  
  OBJECTIVE
  To investigate bone alterations and serum levels of vitamin D in patients with IBD.
  
  
  METHODS
  This was a cross-sectional study based on a review of medical records of patients from a private office in Curitiba, PR, Brazil. Serum levels of vitamin D and bone densitometry were measured at diagnosis of IBD. A total of 105 patients were included; 38 (58.4%) with CD; 27 (41.6%) with UC and 40 with irritable bowel syndrome (IBS) as comparison group.
  
  
  RESULTS
  When compared to patients with UC, CD patients showed a higher prevalence of bone alterations, being 15.8% with osteoporosis and 36.8% with osteopenia. In UC, bone alterations occurred in 29.6% of cases, 3.7% with osteoporosis and 25.9% with osteopenia. As for vitamin D levels, among CD patients, 10.5% had vitamin deficiency, 65.8% insufficiency and 23.7% were sufficient. In UC, 7.4% of cases had deficiency, 74.1% insufficiency and 18.5% had sufficient serum levels of vitamin D. In the group with IBS, deficiency was observed in 17.5% of cases, insufficiency in 55% and sufficiency in 27.5% of them. There was no significant difference between groups.
  
  
  CONCLUSIONS
  IBD patients have a high prevalence of bone changes, especially those with CD. Serum levels of vitamin D are below the recommended in all the evaluated groups.
authors.affiliation: Medical School, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
authors.forename: Lorete Maria da Silva
authors.initials: LM
authors.lastname: Kotze
authors.affiliation: Department of Medicine, Faculdade Evangélica do Paraná, Curitiba, PR, Brazil.
authors.forename: Carolina Tabata
authors.initials: CT
authors.lastname: Costa
authors.affiliation: Department of Medicine, Faculdade Evangélica do Paraná, Curitiba, PR, Brazil.
authors.forename: Murilo Franco
authors.initials: MF
authors.lastname: Cavassani
authors.affiliation: Department of Medicine, Faculdade Evangélica do Paraná, Curitiba, PR, Brazil.
authors.forename: Renato Mitsunori
authors.initials: RM
authors.lastname: Nisihara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology*; D003093:Colitis, Ulcerative / Q000097:blood / Q000150:complications*; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology*; D014808:Vitamin D Deficiency / Q000209:etiology*; D055815:Young Adult