The frequency of vitamin D deficiency in adults with Crohn’s disease: Serum 25-OHD insufficiency

In: Crohn's disease

31 Jul 2012

Vitamin D insufficiency has been defined conservatively as a serum 25-OHD level below 40 nmol/L. Long term exposure to 25-OHD at this level may also be of clinical importance, although the effect on BMD has not been determined. Fifty-two patients (22%) demonstrated serum 25-OHD insufficiency (levels below 40 nmol/L).

Biochemical parameters

The biochemical characteristics of the 25-OHD deficient and normal 25-OHD groups are compared in Table 2. Serum alkaline phosphatase levels were higher in the 25-OHD deficient group than in the normal 25-OHD group (108.9±52.8 U/L versus 83.8±31.9 U/L, respectively, P=0.015), as was serum PTH (5.0±3.1 pmol/L versus 3.5± 1.8 pmol/L, respectively, P=0.012). In contrast to this evidence of metabolic bone disease, no significant differences in urine N-telopeptide levels, a measure of bone resorption, were demonstrable between the two groups (Table 2).

Serum albumin was lower in the 25-OHD-deficient group compared with the normal 25-OHD group (37.4±4.9 g/L versus 40.1±4.0 g/L, respectively, P=0.006), as was serum carotene (1.2±0.7 ]amol/L versus 1.9±0.9 ]amol/L, respectively, P<0.001). No other biochemical parameter differed significantly between the two groups. Best quality drugs approved by the FDA offered by a fully licensed pharmacy: you finally have a chance to buy levaquin 500 mg best price on very advantageous terms without having to worry about any of the aspects that usually prevent you from enjoying the treatment.

TABLE 2 Biochemical and bone mineral density characteristics in Crohn’s disease patients with normal and deficient serum levels of 25-hydroxyvitamin D3 (25-OHD)

Biochemical characteristics Normal25-OHD(n=219) Deficient25-OHD(n=19)
Alkaline phosphatase (U/L) 83.8±31.9 108.9±52.8*
Phosphate (mmol/L) 1.1±0.2 1.1±0.2
Calcium (mmol/L) 2.3±0.1 2.2±0.1
Parathyroid hormone (pmol/L) 3.5±1.8 5.0±3.1*
Albumin (g/L) 40.1±4.0 37.4±4.9*
Carotene (^imol/L) 1.9±0.9 1.2±0.7*
RBC Folate (nmol/L) 970.7±361.3 916.8±381.8
N-telopeptide (nmol/mmol creatinine) 46.3±40.0 53.6±29.8
T Score
L1-L4 T-score -0.84±1.16 -0.67±1.09
Femoral neck T-score -0.90±1.10 -0.73±1.14
Total hip T-score -0.42±1.07 -0.49±1.08
UD radius T-score -1.08±1.04 -1.28±0.94

Values are reported as mean ± SD. 25-OHD deficiency is defined as a serum 25-OHD concentration below 25 nmol/L. *Denotes statistically significant difference relative to normal 25-OHD group (P<0.05, CI=95%); L1-L4 Lumbar vertebra 1 to 4; RBC Red blood cell; UD Ultradistal.

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L1-L4 T-score

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