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Vitamin D Insufficiency/Deficiency in Gastrointestinal Disorders
Author(s) -
Bikle Daniel D
Publication year - 2007
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.07s208
Subject(s) - osteomalacia , vitamin d and neurology , osteoporosis , medicine , vitamin d deficiency , metabolic bone disease , endocrinology , calcium metabolism , calcium , etiology , bone remodeling , rickets , gastroenterology
Vitamin D and calcium are critical for skeletal health. Their absorption from the intestine is negatively impacted by a number of gastrointestinal diseases and surgical procedures, leading to osteoporosis and/or osteomalacia. Diseases of the liver can impact the metabolism of vitamin D to its circulating form, 25(OH)D, as well as the production of carrier proteins, albumin and vitamin D–binding protein, that may alter the delivery of 25(OH)D and its active metabolite 1,25(OH) 2 D to target tissues, including the skeleton, again leading to bone disease. The clinician evaluating a patient with apparent osteoporosis and vitamin D deficiency/ insufficiency needs to consider a gastrointestinal etiology. Similarly, the clinician evaluating a patient with a gastrointestinal disorder needs to evaluate that patient for vitamin D deficiency and bone disease. Treatment involves adequate vitamin D and calcium supplementation to achieve normal serum 25(OH)D, PTH, and serum and urine calcium levels.