期刊
INFLAMMATORY BOWEL DISEASES
卷 19, 期 1, 页码 45-53出版社
OXFORD UNIV PRESS INC
DOI: 10.1002/ibd.22969
关键词
Crohn's disease; children; 25(OH)D; 1,25(OH)(2)D; parathyroid hormone
资金
- National Institutes of Health (NIH) [R01DK60030, K23 DK082012, K24 DK076808, R01 DK068164]
- North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition
- Children's Hospital of Philadelphia Clinical Translational Research Center [UL1 RR024134]
Background: Prior studies of vitamin D metabolism in Crohn's disease (CD) did not include controls or examine changes following diagnosis. This study examined associations among 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)(2)D], and parathyroid hormone (PTH) levels in incident pediatric CD, compared with controls, and following diagnosis. Methods: Serum vitamin D and PTH were measured at diagnosis (n = 78), 6, 12, and a median of 43 months (n = 52) later in CD participants, and once in 221 controls. Multivariate regression was used to examine baseline associations and quasi-least squares regression to assess subsequent changes. Results: At diagnosis, 42% of CD participants were 25(OH)D-deficient (<20 ng/mL). The odds ratio for deficiency was 2.1 (95% confidence interval [CI]: 1.1, 3.9; P < 0.05) vs. controls, adjusted for age, race, and season. 1,25(OH)(2)D was lower in CD vs. controls (P < 0.05), adjusted for 25(OH)D, tumor necrosis factor alpha (TNF-alpha), and PTH. TNF-alpha was associated with lower 1,25(OH)(2)D (P < 0.05), and the positive association between PTH and 1,25(OH)(2)D in controls was absent in CD (interaction P = 0.02). Among participants with 25(OH)D <30 ng/mL, CD was associated with lower PTH (P < 0.05) vs. controls. Following diagnosis, 25(OH)D and 1,25(OH)(2)D improved (P < 0.001). At the final visit, 3% were 25(OH)D-deficient, PTH was no longer low relative to 25(OH)D, and 1,25(OH)(2)D was significantly elevated (P < 0.001) compared with controls. Conclusions: Incident CD was associated with 25(OH)D and 1,25(OH)(2)D deficiency and a relative hypoparathyroidism that resolved following diagnosis. Inflammatory cytokine suppression of PTH and renal 1-alpha-hyroxylase may contribute to these alterations. (Inflamm Bowel Dis 2013;19:45-53)
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据