饮食、阳光、体力活动与炎症性肠病患儿的维生素 D 状态。

Diet, Sun, Physical Activity and Vitamin D Status in Children with Inflammatory Bowel Disease.

机构信息

Department of Internal and Pediatric Nursing, Faculty of Health Sciences with Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland.

Department of Pediatrics, Pediatric Gastroenterology, Allergology and Nutrition, Medical University of Gdansk, 80-803 Gdansk, Poland.

出版信息

Nutrients. 2022 Feb 28;14(5):1029. doi: 10.3390/nu14051029.

DOI:10.3390/nu14051029

PMID:35268001

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8912613/

Abstract

In the course of inflammatory bowel disease (IBD) malabsorption may lead to a vitamin D deficiency and calcium-phosphate misbalance. However, the reports on the vitamin D status in children with IBD are few and ambiguous. Here, we are presenting complex analyses of multiple factors influencing 25OHD levels in IBD children ( = 62; Crohn's disease = 34, ulcerative colitis = 28, mean age 14.4 ± 3.01 years, F/M 23/39) and controls ( = 47, mean age 13.97 ± 2.57, F/M 23/24). Additionally, calcium-phosphate balance parameters and inflammatory markers were obtained. In children with IBD disease, activity and location were defined. Information about therapy, presence of fractures and abdominal surgery were obtained from medical records. All subjects were surveyed on the frequency and extent of exposure to sunlight (forearms, partially legs for at least 30 min a day), physical activity (at least 30 min a day) and diet (3 days diary was analyzed with the program DIETA 5). The mean 25OHD level was higher in IBD patients compared to controls (18.1 ng/mL vs. 15.5 ng/mL; = 0.03). Only 9.7% of IBD patients and 4.25% of controls had the optimal vitamin D level (30-50 ng/mL). Despite the higher level of 25OHD, young IBD patients showed lower calcium levels in comparison to healthy controls. There was no correlation between the vitamin D level and disease activity or location of gastrointestinal tract lesions. Steroid therapy didn't have much influence on the vitamin D level while vitamin D was supplemented. Regular sun exposure was significantly more common in the control group compared to the IBD group. We found the highest concentration of vitamin D (24.55 ng/mL) with daily sun exposure. There was no significant correlation between the vitamin D level and frequency of physical activity. The analysis of dietary diaries showed low daily intake of vitamin D in both the IBD and the control group (79.63 vs. 85.14 IU/day). Pediatric patients, both IBD and healthy individuals, require regular monitoring of serum vitamin D level and its adequate supplementation.

摘要

在炎症性肠病（IBD）中，吸收不良可能导致维生素 D 缺乏和钙磷失衡。然而，关于 IBD 患儿维生素 D 状态的报道很少且存在歧义。在这里，我们对影响 IBD 患儿（=62；克罗恩病=34，溃疡性结肠炎=28，平均年龄 14.4±3.01 岁，男女比例 23/39）和对照组（=47，平均年龄 13.97±2.57，男女比例 23/24）25OHD 水平的多种因素进行了复杂分析。此外，还获得了钙磷平衡参数和炎症标志物。在 IBD 患儿中，对疾病的活动度和位置进行了定义。从病历中获取了关于治疗、骨折和腹部手术的信息。所有受试者均接受了关于日光暴露频率和程度的调查（前臂，至少每天部分腿部暴露 30 分钟）、体力活动（至少每天 30 分钟）和饮食（3 天饮食日记，用程序 DIETA 5 进行分析）。与对照组相比，IBD 患儿的平均 25OHD 水平更高（18.1ng/ml 比 15.5ng/ml；=0.03）。只有 9.7%的 IBD 患儿和 4.25%的对照组患儿的维生素 D 水平达到最佳水平（30-50ng/ml）。尽管 25OHD 水平较高，但年轻的 IBD 患儿的血钙水平仍低于健康对照组。维生素 D 水平与胃肠道病变的疾病活动度或位置之间无相关性。尽管补充了维生素 D，但类固醇治疗对维生素 D 水平的影响不大。与 IBD 组相比，对照组经常进行规律的阳光照射。我们发现，每天进行阳光照射时，维生素 D 的浓度最高（24.55ng/ml）。维生素 D 水平与体力活动频率之间无显著相关性。饮食日记分析显示，IBD 组和对照组的维生素 D 日摄入量均较低（79.63IU/天比 85.14IU/天）。儿科患者，包括 IBD 患儿和健康个体，需要定期监测血清维生素 D 水平并进行适当补充。