Villanueva Jeffrey, Maranda Louise, Nwosu Benjamin Udoka
University of Massachusetts Medical School, Worcester, 01655, USA.
J Pediatr Endocrinol Metab. 2012;25(5-6):607-10. doi: 10.1515/jpem-2012-0048.
Celiac disease (CD) is an autoimmune enteropathy characterized by villus atrophy and malabsorption of essential nutrients. Vitamin D deficiency has been described in autoimmune diseases, but its status in prepubertal children with CD has not been adequately studied.
To determine the vitamin D status of prepubertal children with CD.
A retrospective study of prepubertal children aged 3-12 years with CD (n=24) who were compared to prepubertal, non-CD children of the same age (n=50). Children were included in the study if they had a diagnosis of CD by intestinal biopsy, and were not on a gluten-free diet (GFD). Patients were excluded if they had diseases of calcium or vitamin D metabolism, or were receiving calcium or vitamin D supplementation or had other autoimmune diseases. All subjects had their serum 25-hydroxyvitamin D [25(OH)D] level measured.
There was no difference in 25(OH)D level between the CD and non-CD children (27.58 +/- 9.91 versus 26.20 +/- 10.45, p = 0.59). However, when the patients were subdivided into obese and non-obese groups, the non-obese CD patients had a significantly higher 25(OH)D level than the obese normal children (28.39 +/- 10.26 versus 21.58 +/- 5.67, p = 0.009). In contrast, there was no difference in 25(OH)D level between non-obese CD patients and non-obese normal children (28.39 +/- 10.26 versus 30.64 +/-12.08, p = 0.52). The season of 25(OH)D measurement was not a significant confounder (p =0.7).
Our data showed no difference in 25(OH) D levels between normal children and those with CD when adjusted for body mass index.
乳糜泻（CD）是一种自身免疫性肠病，其特征为绒毛萎缩和必需营养素吸收不良。维生素D缺乏在自身免疫性疾病中已有报道，但在青春期前患有CD的儿童中其状况尚未得到充分研究。
确定青春期前患有CD的儿童的维生素D状况。
对24名3至12岁患有CD的青春期前儿童进行回顾性研究，并与50名同年龄的非CD青春期前儿童进行比较。如果儿童通过肠道活检确诊为CD且未采用无麸质饮食（GFD），则纳入研究。如果患有钙或维生素D代谢疾病、正在接受钙或维生素D补充剂或患有其他自身免疫性疾病，则排除患者。所有受试者均测量了血清25-羟基维生素D [25(OH)D]水平。
CD组和非CD组儿童的25(OH)D水平无差异（27.58±9.91对26.20±10.45，p = 0.59）。然而，当将患者分为肥胖组和非肥胖组时，非肥胖的CD患者的25(OH)D水平显著高于肥胖的正常儿童（28.39±10.26对21.58±5.67，p = 0.009）。相比之下，非肥胖的CD患者和非肥胖的正常儿童之间的25(OH)D水平无差异（28.39±10.26对30.64±12.08，p = 0.52）。测量25(OH)D的季节不是一个显著的混杂因素（p = 0.7）。
我们的数据显示，调整体重指数后，正常儿童和患有CD的儿童之间的25(OH)D水平无差异。
