title: Supplementation with 2000 IU of Cholecalciferol Is Associated with Improvement of Trabecular Bone Mineral Density and Muscle Power in Pediatric Patients with IBD.
abstract: Inflammatory bowel diseases (IBD) are associated with altered bone health and increased risk for fractures. Vitamin D deficiency is frequently found in IBD; however, the effect of vitamin D supplementation on bone health of children with IBD is poorly understood. We aimed to observe the changes in volumetric bone density and dynamic muscle functions after vitamin D substitution in a cohort of pediatric patients with IBD.
  
  
  
  This was a prospective observational study of 55 patients (aged 5-19 years) with IBD. Bone quality was assessed using peripheral quantitative computed tomography and muscle functions by jumping mechanography at baseline and after a median of 13.8 (interquartile range, 12.0-16.0) months of daily substitution of 2000 IU of cholecalciferol.
  
  
  
  Median serum levels of 25-hydroxyvitamin D increased from 58 nmol/L at the baseline visit to 85 nmol/L at the last follow-up visit (P < 0.001); no signs of overdose were reported. The Z-scores of trabecular bone mineral density, cortical bone cross-sectional area, and maximal muscle power improved significantly during the follow-up period (+0.5, P = 0.001, +0.3, P = 0.002 and +0.5, P = 0.002, respectively). Cholecalciferol substitution was positively associated with trabecular bone mineral density and maximal muscle power (estimates 0.26, 95% confidence interval 0.14-0.37, P < 0.0001 and 0.60, 95% confidence interval 0.32-0.85, P < 0.0001, respectively) but not with the Strength-Strain Index or maximal muscle force (Fmax).
  
  
  
  We observed an improvement in bone and muscle parameters after cholecalciferol substitution in pediatric patients with IBD. Therefore, vitamin D substitution can be considered in such patients.
authors.affiliation: Department of Pediatrics, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Hradsky
authors.forename: Ondrej
authors.initials: O
authors.lastname: Soucek
authors.forename: Klara
authors.initials: K
authors.lastname: Maratova
authors.forename: Jana
authors.initials: J
authors.lastname: Matyskova
authors.forename: Ivana
authors.initials: I
authors.lastname: Copova
authors.forename: Kristyna
authors.initials: K
authors.lastname: Zarubova
authors.forename: Jiri
authors.initials: J
authors.lastname: Bronsky
authors.forename: Zdenek
authors.initials: Z
authors.lastname: Sumnik
mesh_terms: D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D050071:Bone Density Conservation Agents / Q000008:administration & dosage*; D000071556:Cancellous Bone / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D002762:Cholecalciferol / Q000008:administration & dosage*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D053580:Muscle Strength / Q000187:drug effects*; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D050071:Bone Density Conservation Agents; D002762:Cholecalciferol