Open AccessVitamin D Deficiency and Low Bone Mineral Density in Pediatric and Young Adult Intestinal Failure
Author(s) -
Ubesie Agozie C.,
Heubi James E.,
Kocoshis Samuel A.,
Henderson Carol J.,
Mezoff Adam G.,
Rao Marepalli B.,
Cole Conrad R.
Publication year - 2013
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e31829c10eb
Subject(s) - medicine , vitamin d deficiency , bone mineral , vitamin d and neurology , gastroenterology , univariate analysis , bone density , logistic regression , pediatrics , osteoporosis , multivariate analysis
Objectives: The aim of the present study was to determine the prevalence and predisposing factors for vitamin D deficiency and low bone mineral density (BMD) in patients with intestinal failure (IF). Methods: A retrospective review of patients with IF managed at the Cincinnati Children's Hospital Medical Center. IF was defined as history of parenteral nutrition (PN) >30 days. Vitamin D deficiency was defined as serum 25‐hydroxyvitamin D (25 (OH) D) <20 ng/dL. Reduced BMD was defined using dual x‐ray absorptiometry z score ≤–2. A binary logistic regression model was used to test for association of significant risk factors and the outcome variables after univariate analyses. Results: One hundred and twenty‐three patients with median age of 4 years (range 3–22 years) were evaluated. Forty‐nine (39.8%) patients had at least a documented serum 25 (OH) D deficiency during the study interval, whereas 10 of 80 patients (12.5%) with dual x‐ray absorptiometry scans completed had a low BMD z score. Age at study entry was associated with both 25 (OH) D deficiency ( P = 0.01) and low BMD z score ( P = 0.03). Exclusive PN at study entry was associated with reduced bone mass ( P = 0.03). There was no significant association between vitamin D deficiency and low BMD z score ( P = 0.31). Conclusions: The risk of 25 (OH) D deficiency and low BMD z score increases with age among patients with IF. Strategies for monitoring and preventing abnormal bone health in older children receiving exclusive PN need to be developed and evaluated.