*Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Emory School of Medicine and Children's Healthcare of Atlanta †Department of Medicine, Division of Endocrinology, Metabolism, and Lipids ‡Department of Human Genetics, Emory University School of Medicine, Atlanta, GA.
J Pediatr Gastroenterol Nutr. 2013 Nov;57(5):587-93. doi: 10.1097/MPG.0b013e31829e0b89.
Vitamin D deficiency and low bone mineral density (BMD) are complications of inflammatory bowel disease. Vitamin D deficiency is more prevalent among African Americans compared with whites. There are little data comparing differences in serum 25-hydroxyvitamin D (25OHD) concentrations and BMD between African American and white children with Crohn disease (CD).
We compared serum 25OHD concentrations of African American children with CD (n = 52) to white children with CD (n = 64) and healthy African American controls (n = 40). We also analyzed BMD using dual-energy x-ray absorptiometry results from our pediatric CD population.
African American children with CD had lower serum 25OHD concentrations (16.1 [95% confidence interval, CI 14.5-17.9] ng/mL) than whites with CD (22.3 [95% CI 20.2-24.6] ng/mL; P < 0.001). African Americans with CD and controls exhibited similar serum 25OHD concentration (16.1 [95% CI 14.5-17.9] vs 16.3 [95% CI 14.4-18.4] ng/mL; NS). African Americans with CD exhibited no difference in serum 25OHD concentration when controlling for seasonality, disease severity, and surgical history, although serum 25OHD concentration was significantly decreased in overweight children (body mass index ≥85%, P = 0.003). Multiple regression analysis demonstrated that obese African American girls with CD had the lowest serum 25OHD concentrations (9.6 [95% CI 6.8-13.5] ng/mL). BMD was comparable between African American and white children with CD (z score -0.4 ± 0.9 vs -0.7 ± 1.2; NS).
African American children with CD are more likely to have vitamin D deficiency compared with white children with CD, but have similar BMD. CD disease severity and history of surgery do not affect serum 25OHD concentrations among African American children with CD. African American children have low serum 25OHD concentrations, independent of CD, compared with white children. Future research should focus on how race affects vitamin D status and BMD in children with CD.
维生素 D 缺乏和低骨密度（BMD）是炎症性肠病的并发症。与白人相比，非裔美国人中维生素 D 缺乏更为普遍。目前，比较非裔美国儿童与白人儿童克罗恩病（CD）患者血清 25-羟维生素 D（25OHD）浓度和 BMD 差异的数据较少。
我们比较了 52 例非裔美国 CD 患儿（n=52）与 64 例白人 CD 患儿（n=64）和 40 例健康非裔美国对照组（n=40）的血清 25OHD 浓度。我们还利用我们儿科 CD 人群的双能 X 线吸收法（DXA）结果分析了 BMD。
非裔美国 CD 患儿的血清 25OHD 浓度（16.1 [95%置信区间，CI 14.5-17.9]ng/mL）低于白人 CD 患儿（22.3 [95%CI 20.2-24.6]ng/mL；P<0.001）。非裔美国 CD 患儿和对照组的血清 25OHD 浓度相似（16.1 [95%CI 14.5-17.9]与 16.3 [95%CI 14.4-18.4]ng/mL；NS）。尽管超重儿童（体重指数≥85%，P=0.003）的血清 25OHD 浓度显著降低，但在控制季节性、疾病严重程度和手术史后，非裔美国 CD 患儿的血清 25OHD 浓度无差异。多元回归分析显示，肥胖的非裔美国 CD 女孩血清 25OHD 浓度最低（9.6 [95%CI 6.8-13.5]ng/mL）。非裔美国和白人 CD 患儿的 BMD 相当（z 评分-0.4 ± 0.9 与-0.7 ± 1.2；NS）。
与白人 CD 患儿相比，非裔美国 CD 患儿更易发生维生素 D 缺乏，但 BMD 相似。CD 疾病严重程度和手术史并不影响非裔美国 CD 患儿的血清 25OHD 浓度。与白人儿童相比，非裔美国儿童无论是否患有 CD，其血清 25OHD 浓度均较低。未来的研究应重点关注种族如何影响 CD 患儿的维生素 D 状态和 BMD。
