Vitamin D deficiency common in IBD kids

By Stephen Daniells

- Last updated on GMT

Related tags Vitamin d deficiency Inflammatory bowel disease Vitamin d Ulcerative colitis

Children and adolescents with inflammatory bowel disease (IBD) are
at an increased risk of vitamin D deficiency and could benefit from
supplements to avoid the health problems associated with not
getting enough of the vitamin.

Inflammatory bowel disease (IBD) is said to affect about one person in every 500, which equates to over half a million people in the US, and 150,000 people in the UK. Current methods of treating or managing the disease are limited to a range of drugs and surgical intervention.

Lead researcher Helen Pappa, from Children's Hospital Boston, Massachusetts, told "One of the study's findings was a strong correlation between albumin level and vitamin D level, which may point to a "leaky gut" as one of the mechanisms for low vitamin D in this population."

The new research, published in the journal Pediatrics​, analysed the blood levels of vitamin D for 130 IBD patients (age range 8-22). Ninety-four of the patients had Crohn's disease and 36 had ulcerative colitis. Measures of parathyroid hormone and lumbar spine bone mineral density were also taken.

Vitamin D is produced in the skin on exposure to UVB radiation and can also be consumed in small amounts from the diet. However, recent studies have shown that sunshine levels in some northern countries are so weak during the winter months that the body makes no vitamin D at all, leading some to estimate that over half of the population in such countries have insufficient or deficient levels of the vitamin.

Increased skin pigmentation also reduces the effect of UVB radiation meaning darker skinned people are more at risk.

Vitamin D deficiency can lead to a range of health problems, including rickets, poor tooth formation, convulsions, general ill health, and stunted growth. It has also been linked to an increased risk of certain cancers, cardiovascular disease, diabetes, and osteoporosis.

The researchers reported that the prevalence of vitamin D deficiency was 34.6 per cent, with similar levels in both Crohn's disease and ulcerative colitis patients. In patients with increased skin pigmentation serum levels of 25-hydroxy-vitamin D were about 53 per cent lower, and during the winter months the average 25-hydroxy-vitamin D level in all the subjects was 33 per cent lower.

The patients taking regular vitamin D supplements had serum vitamin D levels 31.5 per cent higher than those not taking supplements.

"Vitamin D deficiency is highly prevalent among paediatric patients with inflammatory bowel disease,"​ wrote the researchers in Pediatrics. "Factors predisposing to the problem include having a dark-skin complexion, winter season, lack of vitamin D supplementation, early stage of disease, more severe disease, and upper gastrointestinal tract involvement in patients with Crohn disease."

The research merely links IBD to low serum vitamin D levels and there is not suggestion that vitamin D deficiency is the cause of IBD. Dr. Pappa told this website however that prospective epidemiologic studies would be needed to check this "interesting hypothesis"​.

Further research to examine the relationship is clearly merited and Dr. Pappa said: "Our centre is planning prospective studies of the benefits of vitamin D supplementation on multiple aspects of the health of children with IBD."

Source: Pediatrics​ Volume 118, Number 5, November 2006, pp. 1950-1961 (doi:10.1542/peds.2006-0841) "Vitamin D Status in Children and Young Adults With Inflammatory Bowel Disease"​ Authors: H. Pappa, C. Gordon, T. Saslowsky, A. Zholudev, B. Horr, M-C. Shih, R. Grand

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