Ratajczak Alicja E, Szymczak-Tomczak Aleksandra, Michalak Michał, Rychter Anna M, Zawada Agnieszka, Dobrowolska Agnieszka, Krela-Kaźmierczak Iwona
Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland; Doctoral School, Poznan University of Medical Sciences, Poznań, Poland.
Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland
Pol Arch Intern Med. 2022 Dec 21;132(12). doi: 10.20452/pamw.16329. Epub 2022 Aug 26.
There are various factors contributing to the pathogenesis of osteoporosis in inflammatory bowel disease (IBD), including steroid therapy, malnutrition, and vitamin D deficiency.
The study aimed to assess the vitamin D level among IBD patients and to investigate the relationship between vitamin D concentration and bone mineral density (BMD).
The study participants included 239 adult patients with IBD and a control group of 45 healthy adults. Densitometric measurements of the lumbar spine (L1-L4) and femoral neck (FN) were conducted using dual‑energy X‑ray absorptiometry. All patients completed a questionnaire referring to vitamin D supplementation.
Significant differences were observed with regard to the body mass, body mass index, BMD, the Z‑score, and the T‑score of the FN and L1-L4. Only approximately 25% of all participants presented optimal or high concentrations of vitamin D. The research revealed no differences in vitamin D levels with regard to the disease extent and severity among the patients with ulcerative colitis. No differences were observed in terms of the disease localization, behavior, and the patient age at the time of diagnosis in the patients with Crohn disease. Furthermore, no differences were found in BMD, T‑score, and Z‑score of the FN and L1-L4 between the group of patients who supplemented and did not supplement vitamin D.
Vitamin D may not be the only factor affecting BMD. Patients with IBD should supplement a higher dose of vitamin D than healthy adults.
有多种因素导致炎症性肠病(IBD)中骨质疏松症的发病机制,包括类固醇治疗、营养不良和维生素D缺乏。
本研究旨在评估IBD患者的维生素D水平,并调查维生素D浓度与骨矿物质密度(BMD)之间的关系。
研究参与者包括239名成年IBD患者和45名健康成年人组成的对照组。使用双能X线吸收法对腰椎(L1-L4)和股骨颈(FN)进行骨密度测量。所有患者均完成了一份关于维生素D补充剂的问卷。
在体重、体重指数、BMD、FN和L1-L4的Z评分和T评分方面观察到显著差异。所有参与者中只有约25%的人维生素D浓度处于最佳或高水平。研究发现,溃疡性结肠炎患者的维生素D水平在疾病范围和严重程度方面没有差异。在克罗恩病患者中,在疾病定位、行为和诊断时的患者年龄方面未观察到差异。此外,补充和未补充维生素D的患者组之间,FN和L1-L4的BMD、T评分和Z评分没有差异。
维生素D可能不是影响BMD的唯一因素。IBD患者应比健康成年人补充更高剂量的维生素D。