Joseph A J, George Biju, Pulimood A B, Seshadri M S, Chacko Ashok
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
Indian J Med Res. 2009 Aug;130(2):133-7.
BACKGROUND & OBJECTIVE: Western studies show that up to 65 per cent of patients with Crohn's disease have low serum 25-hydroxy vitamin D concentrations, and 45 per cent of these patients have metabolic bone disease. No data are available from India or from any country with comparable climatic conditions or ethnicity. We carried out this study to measure the serum 25 (OH) vitamin D levels of Crohn's disease patients and compare with matched controls and to assess the consequences of low 25 (OH) vitamin D levels on bone and mineral metabolism in these patients.
Adult patients with Crohn's disease were compared with age and sex matched patients diagnosed to have irritable bowel syndrome. Serum 25 (OH) vitamin D, the effect of disease characteristics, sunlight exposure and milk consumption on 25 (OH) vitamin D level, and the consequences of low 25 (OH) vitamin D level on bone and mineral metabolism were assessed.
Thirty four patients with Crohn's disease (M:F, 24:10, age 39.2 +/- 12.9 yr) and 34 controls (M:F, 24:10, age 38.9 +/- 13.4 yr) were studied. 25 (OH) vitamin D levels were significantly lower in patients with Crohn's disease as compared to controls (Crohn's disease vs controls: 16.3 +/- 10.8 vs 22.8 +/- 11.9 ng/ml; P<0.05). The severity of disease activity as assessed by the Harvey Bradshaw score correlated negatively (Correlation coefficient -0.484, significance P<0.004), and the duration of sunlight exposure correlated positively (Correlation coefficient 0.327, significance P=0.007) with the serum 25 (OH) vitamin D level.
INTERPRETATION & CONCLUSION: Serum 25 (OH) vitamin D levels were significantly lower among patients with Crohn's disease as compared to age and sex matched controls. Further, 25 (OH) vitamin D levels in patients with Crohn's disease were lower in those with severe disease activity and less sun exposure. Further studies need to be done to correlate low 25 (OH) vitamin D level with bone density and assess the effect of vitamin D supplementation in these patients.
西方研究表明，高达65%的克罗恩病患者血清25-羟维生素D浓度较低，其中45%的患者患有代谢性骨病。印度或任何气候条件或种族类似的国家均无相关数据。我们开展此项研究以测定克罗恩病患者的血清25（OH）维生素D水平，并与匹配的对照组进行比较，同时评估低25（OH）维生素D水平对这些患者骨骼和矿物质代谢的影响。
将成年克罗恩病患者与年龄和性别匹配的诊断为肠易激综合征的患者进行比较。评估血清25（OH）维生素D、疾病特征、阳光暴露和牛奶摄入量对25（OH）维生素D水平的影响，以及低25（OH）维生素D水平对骨骼和矿物质代谢的影响。
研究了34例克罗恩病患者（男:女，24:10，年龄39.2±12.9岁）和34例对照者（男:女，24:10，年龄38.9±13.4岁）。与对照组相比，克罗恩病患者的25（OH）维生素D水平显著较低（克罗恩病患者与对照组：16.3±10.8 vs 22.8±11.9 ng/ml；P<0.05）。根据哈维·布拉德肖评分评估的疾病活动严重程度与血清25（OH）维生素D水平呈负相关（相关系数-0.484，P<0.004），阳光暴露时长与血清25（OH）维生素D水平呈正相关（相关系数0.327，P=0.007）。
与年龄和性别匹配的对照组相比，克罗恩病患者的血清25（OH）维生素D水平显著较低。此外，疾病活动严重且阳光暴露较少的克罗恩病患者的25（OH）维生素D水平较低。需要进一步研究以关联低25（OH）维生素D水平与骨密度，并评估维生素D补充剂对这些患者的影响。
