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 (N = 62; Crohn’s disease n = 34, ulcerative colitis n = 28, mean age 14.4 ± 3.01 years, F/M 23/39) and controls (n = 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; p = 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.
Highlights
The contribution of vitamin D in the regulation of the calcium–phosphate balance and its metabolic complications is widely recognized
The highest vitamin D level was seen in inflammatory bowel disease (IBD) patients during the winter; this observation could be explained by vitamin D supplementation (Table 3)
Both children with IBD and the control group reported a vitamin D deficiency which suggests the need for vitamin D supplementation in children with inflammatory bowel disease as well as their healthy peers, especially in adolescents
Summary
The contribution of vitamin D in the regulation of the calcium–phosphate balance and its metabolic complications (rickets, osteoporosis, osteopenia) is widely recognized. Recent studies have highlighted the possible role of vitamin D in the pathogenesis of numerous diseases, including autoimmune, endocrine, metabolic, cardiovascular and gastrointestinal diseases and cancer [1–4]. It is well established that skin production of vitamin D, induced by sun exposure, is its best source. To achieve the optimal serum 25OHD concentration, residents of Central Europe should expose approximately 18% of the body surface area (e.g., forearms and partially leg) without protective sun blockers, 2–3 times a week, for a minimum of 15 min, between 10 a.m. and 3 p.m., from April to September [2]. Ultraviolet B fraction of the sunlight, which is essential for the photo conversion of 7dehydrocholesterol to vitamin D, is a known carcinogen. Limited and controlled exposition to the sun (main source of UVB) is advised [2,5,6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
