Vitamin D levels in Children with Gastrointestinal System Disorders

Yıl 2019, Cilt: 11 Sayı: 4, 542 - 547, 01.12.2019

Halil Kocamaz

https://doi.org/10.21601/ortadogutipdergisi.474979

Cited By: 1

Öz

Vitamin D deficiency is common in gastrointestinal system disorders for various reasons. We aimed to evaluate Vitamin D levels of children who suffer from gastrointestinal system disorders and to identify disease which leads to Vitamin D deficiency commonly. The data and files of children on follow-up at least for 3 months on pediatric gastroenterology outpatient clinic were retrospectively screened between March 2015 and December 2016. Totally 294 patients were included to the study. 138 (47%) were male and 156 (53%) were female of patients. Mean age of patients was 80.04 ± 65.24 (1-225) months. Thirty one (10%) patients had Vitamin D deficiency (<12 ng/ml) and 57 (20%) patients had Vitamin D insufficiency (12-20 ng/ml). Vitamin D deficiency and insufficiency was mostly found in winter season (18% and 29% respectively) and was mostly seen in children with Inflammatory bowel disease, Gastroesophageal reflux disease and Celiac disease. According to the age groups vitamin D deficiency was lower in adolescent age group. In conclusion we emphasized that it would be logical to determine vitamin D levels in adolescent patients and for children with Inflammatory bowel disease, celiac disease and gastroesophageal reflux disease in pediatric gastroenterology outpatient clinic.

Anahtar Kelimeler

child, gastroenterology, vitamin D

Çocukluk çağı gastrointestinal sistem hastalıklarında D vitamini düzeyleri

Öz

Gastrointestinal sistem hastalıklarında D vitamini eksikliğine farklı nedenlerle sık rastlanmaktadır. Bu çalışmanın amacı gastrointestinal sistemi ilgilendiren hastalıkları olan çocukların D vitamini düzeylerini incelemek ve D vitamini izlemi gerektiren hastalık gruplarını belirlemektir. Mart 2015–Aralık 2016 tarihlerinde Çocuk Gastroenterolojisi polikliniğinde en az 3 aydır izlenen ve D vitamini düzeyi belirlenen hastaların dosyaları retrospektif olarak incelendi.  Çalışmaya toplam 294 hasta dâhil edildi. Hastaların 138’i (%47) erkek, 156’sı (%53) kız idi. Hastaların ortalama yaşı 80,04 ± 65,24 (1-225) ay idi. Otuz bir hastada (%10) D vitamini eksikliği (<12 ng/ml) ve 57 hastada (%20) D vitamini yetersizliği (12-20 ng/ml) tespit edildi. D vitamini eksikliği ve yetersizliği en fazla kış mevsiminde (sırasıyla %18 ve %29) yapılan analizlerde tespit edildi. D vitamini eksikliği ve yetersizliği en sık inflamatuvar bağırsak hastalığı, Gastroözofageal reflü hastalığı ve Çölyak hastalığı olan hastalarda tespit edildi. Yaş gruplarına göre en düşük D vitamini düzeyleri adolesan yaştaki hastalarda izlendi. Sonuç olarak çocuk gastroenterolojisi polikliniğinde adolesan yaştaki hastalar ile inflamatuvar bağırsak, çölyak ve gastroözofageal reflü hastalığı olan çocukların D vitamini eksikliği açısından izlenmesinin yararlı olacağı kanısına varıldı.

Anahtar Kelimeler

çocuk, gastroenteroloji, vitamin D

Kaynakça

• Holick MF. Vitamin D deficiency. N Engl J Med. 2007; 357: 266-81.
• Holick MF, MacLaughlin JA, Clark MB, Holick SA, Potts JT Jr, Anderson RR, P. ve ark. Photosynthesis of previtamin D3 in human skin and the physiologic consequences. Science. 1980; 210: 203-5.
• Lee JY, So TY, Thackray J. A review on vitamin d deficiency treatment in pediatric patients. J Pediatr Pharmacol Ther. 2013; 18(4): 277-91.
• Yin K, Agrawal DK. Vitamin D and inflammatory diseases. J Inflamm Res 2014; 7: 69-87.
• Poskitt EM, Cole TJ, Lawson DE. Diet, sunlight, and 25-hydroxy vitamin D in healthy children and adults. Br Med J 1979; 1: 221-3.
• Devgun MS, Paterson CR, Johnson BE, Cohen C. Vitamin D nutrition in relation to season and occupation. Am J Clin Nutr 1981; 34: 1501-4.
• Mouli VP, Ananthakrishnan AN. Review article: vitamin D and inflammatory bowel diseases. Aliment Pharmacol Ther 2014; 39: 125-136.
• Wierdsma NJ, van Bokhorst-de van der Schueren MA, Berkenpas M, Mulder CJ, van Bodegraven AA. Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients. Nutrients 2013; 5: 3975-92.
• Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, ve ark. Global consensus recommendations on prevention and management of nutritional Rickets. J Clin Endocrinol Metab 2016; 101: 394-415.
• Ross AC, Manson JE, Abrams SA, Aloia JF, Brannon PM, Clinton SK, ve ark. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011; 96: 53-58.
• Ozhan B, Evrengul H, Agladıoglu SY. Vitamin D Status of Children in an University Hospital in West Turkey. HK J Paediatr 2016; 21: 251-256.
• Demiral M, Sırmagül B, Kirel B. Endokrin Polikliniğine Başvuran Çocuklarda D Vitamini Düzeyleri. Curr Pediatr 2016; 14: 60-6.
• Reinehr T, de Sousa G, Alexy U, Kersting M, Andler W. Vitamin D status and parathyroid hormone in obese children before and after weightloss. Eur J Endocrinol 2007; 157: 225-32.
• Hatun S, Bereket A, Ozkan B, Coşkun T, Köse R, Calıkoğlu AS. Free vitamin D supplementation for every infant in Turkey. Arch Dis Child, 2007; 92: 373-4.
• Akman AO, Tumer L, Hasanoglu A, Ilhan M, Caycı B. The frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int 2011; 53: 968-73.
• Karaguzel G, Dilber B, ve ark. Seasonal vitamin D status of healthy school children and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr 2014; 58: 654-60.
• Rufo PA, Denson LA, Sylvester FA, Szigethy E, Sathya P, Lu Y, ve ark. Health supervision in the management of children and adolescents with IBD: NASPGHAN recommendations. J Pediatr Gastroenterol Nutr 2012; 55: 93–108.
• Pappa HM, Langereis EJ, Grand RJ, Gordon CM. Prevalence and risk factors for hypovitaminosis D in young patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2011; 53: 361–364.
• Alkhouri RH, Hashmi H, Baker RD, Gelfond D, Baker SS. Vitamin and mineral status in patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr 2013; 56: 89–92.
• Mehta P, Furuta GT, Brennan T, Henry ML, Maune NC, Sundaram SS, ve ark. Nutritional State and Feeding Behaviors of Children With Eosinophilic Esophagitis and Gastroesophageal Reflux Disease. J Pediatr Gastroenterol Nutr. 2018 Apr;66(4):603-608.
• Black LJ, Walton J, Flynn A, Kiely M. Adequacy of vitamin D intakes in children and teenagers from the base diet, fortified foods and supplements. Public Health Nutr 2014; 17(4): 721-31.
• Vaezi MF, Yang YX, Howden CW. Complications of Proton Pump InhibitorTherapy. Gastroenterology. 2017; 153(1): 35-48.
• Erdem T, Ferat Ç, Nurdan YA, Halime E, Muhammed Selçuk S, Hamza K, Mukadder Ayşe S. Vitamin and mineral deficiency in children newly diagnosed with celiac disease. Turk J MedSci 2015; 45: 833–836.
• Kavak US, Yüce A, Koçak N, Demir H, Saltik IN, Gürakan F, Ozen H. Bone mineral density in children with untreated and treated celiac disease. J Pediatr Gastroenterol Nutr 2003; 37: 434–436.
• Nwosu BU, Maranda L, Candela N. Vitamin D status in pediatric irritable bowel syndrome. PLoS One. 2017; 12(3): e0173779.
• Antico A, Tozzoli R, Giavarina D, Tonutti E, Bizzaro N. Hypovitaminosis D as predisposing factor for atrophic type A gastritis: a case–control study and review of the literature on the interaction of vitamin D with the immune system. Clinic Rev Allerg Immunol. 2012; 42: 355–364.
• Guo L, Chen W, Zhu H, Chen Y, Wan X, Yang N. Helicobacter pylori induces increased expression of the vitamin D receptor in immune responses. Helicobacter. 2013; 19: 37–47.
• Jin D, Wu S, Zhang YG, Lu R, Xia Y, Dong H, Sun J. Lack of Vitamin D Receptor Causes Dysbiosis and Changes the Functions of the Murine Intestinal Microbiome. Clin Ther. 2015; 37(5): 996-1009.