In: Crohn's disease31 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).
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)
|Alkaline phosphatase (U/L)||83.8±31.9||108.9±52.8*|
|Parathyroid hormone (pmol/L)||3.5±1.8||5.0±3.1*|
|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|
|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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