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Prevalence and Predictors of Vitamin D Deficiency and Response to Oral Supplementation in Patients Receiving Long‐Term Home Parenteral Nutrition
Author(s) -
Bharadwaj Shishira,
Gohel Tushar D.,
Deen Omer J.,
Coughlin Kathleen L.,
Corrigan Mandy L.,
Fisher Jill,
Lopez Rocio,
Shatnawei Abdullah,
Kirby Donald F.
Publication year - 2014
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533614539178
Subject(s) - medicine , parenteral nutrition , odds ratio , vitamin d deficiency , confidence interval , gastroenterology , vitamin d and neurology , vitamin , medical prescription , retrospective cohort study , cohort , short bowel syndrome , pediatrics , pharmacology
Previous studies have suggested a high prevalence of vitamin D deficiency in patients receiving long‐term home parenteral nutrition (HPN). The aim of this study was to determine the prevalence and predictors of vitamin D deficiency in long‐term HPN patients. Methods : A retrospective, institutional review board–approved study was performed on all adult patients followed by the Cleveland Clinic HPN program receiving HPN therapy >6 months between 1989 and 2013 with a 25‐(OH) D 3 level reported. Patients were categorized by serum vitamin D status as follows: sufficient, insufficient, and deficient with respective 25‐(OH) D 3 levels of ≥30 ng/mL, 20–30 ng/mL, and <20 ng/mL. Results : Seventy‐nine patients were categorized based on serum vitamin D status as follows: 35 (44.3%) deficient, 24 (30.4%) insufficient, and 20 (25.3%) sufficient. The mean age of the cohort at the initiation of HPN was 52.0 ± 12.7 years, and 26 (32.9%) were male. The median HPN duration was 39 months, and the most common indication was inflammatory bowel disease (36.7%). Most (82.3%) patients had at least 1 prescription of oral vitamin D supplement (50,000 International Units) during this time. History of jejunal resection (odds ratio [OR], 5.3; 95% confidence interval [CI], 1.9–15.1; P = .002) and lack of oral vitamin D supplementation (OR, 0.7; 95% CI, 0.52–0.93; P = .038) were the strongest predictors of vitamin D deficiency. Conclusion : Vitamin D deficiency is common among patients receiving long‐term HPN despite oral supplementation.