Department of Gastroenterology, Key Laboratory of Chinese Health Ministry, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Dig Dis. 2014 Mar;15(3):116-23. doi: 10.1111/1751-2980.12118.
We aimed to investigate the serum 25-hydroxyvitamin D3 (25[OH]D3 ) levels and bone metabolism in adult Chinese patients with inflammatory bowel disease (IBD) and to evaluate the correlation between vitamin D levels and the disease activity as well as the potential risk factors.
Age- and gender-matched cohort of IBD patients (124 with ulcerative colitis [UC] and 107 with Crohn's disease [CD]) and 122 healthy controls were enrolled in this study. Serum levels of 25(OH)D3 and bone mineral density (BMD) were measured, and the correlation between the two parameters and the severity of the disease as well as the clinical risk factors were analyzed.
Serum 25(OH)D3 levels were lower in UC (10.32 ± 4.46 ng/mL, P < 0.001) and CD patients (11.57 ± 5.02 ng/mL, P = 0.029) than that in healthy controls (12.87 ± 4.40 ng/mL). 25(OH)D3 levels were negatively correlated with the disease severity of both UC (r = -0.371, P < 0.001) and CD (r = -0.285, P = 0.030). The incidences of osteopenia and osteoporosis were high in the IBD patients (37.9% and 3.2% in UC and 30.8% and 4.7% in CD, respectively). Cumulative quantity of glucocorticoids use was significantly associated with osteopenia and osteoporosis in both UC (odds ratio [OR] 1.219, 95% confidence interval [CI] 1.054-1.410, P = 0.008) and CD patients (OR 1.288, 95% CI 1.033-1.606, P = 0.025).
Vitamin D deficiency is likely to occur in Chinese patients with IBD and is closely associated with the severity of the disease. Glucocorticoids accumulation is a risk factor for osteopenia and osteoporosis.
本研究旨在探讨成人炎症性肠病（IBD）患者的血清 25-羟维生素 D3（25[OH]D3）水平和骨代谢情况，并评估维生素 D 水平与疾病活动度的相关性以及潜在的危险因素。
本研究纳入了年龄和性别匹配的 IBD 患者队列（溃疡性结肠炎[UC]患者 124 例，克罗恩病[CD]患者 107 例）和 122 名健康对照者。测量了血清 25（OH）D3 和骨密度（BMD）水平，并分析了这两个参数与疾病严重程度和临床危险因素之间的相关性。
UC（10.32±4.46ng/mL，P＜0.001）和 CD 患者（11.57±5.02ng/mL，P=0.029）的血清 25（OH）D3 水平低于健康对照组（12.87±4.40ng/mL）。25（OH）D3 水平与 UC（r=-0.371，P＜0.001）和 CD（r=-0.285，P=0.030）的疾病严重程度均呈负相关。IBD 患者中骨质疏松和骨量减少的发生率较高（UC 患者分别为 37.9%和 3.2%，CD 患者分别为 30.8%和 4.7%）。累积糖皮质激素使用量与 UC（比值比[OR]1.219，95%置信区间[CI]1.054-1.410，P=0.008）和 CD 患者（OR 1.288，95%CI 1.033-1.606，P=0.025）的骨质疏松和骨量减少均显著相关。
中国 IBD 患者可能存在维生素 D 缺乏，且与疾病严重程度密切相关。糖皮质激素累积是骨质疏松和骨量减少的危险因素。
