Vitamin D Status and Bone Mineral Density in African American Children With Crohn Disease

• Type of Material: Article
• Authors: Jeremy P. Middleton, Emory University; Anita P. Bhagavathula, Emory University; Bilkisu Gaye, Emory University; Jessica A. Alvarez, Emory University; Clifton S. Huang, Emory University; Cary G Sauer, Emory University; Gayathri Tenjarla, Emory University; Bess T Schoen, Emory University; Archana Kumar, Emory University; Mahadev Prasad, Emory University; David T. Okou, Emory University; Walter C. Ifeadike, Emory University; Tanvi Dhere, Emory University; Karen N Conneely, Emory University; Thomas R Ziegler, Emory University; Vin Tangpricha, Emory University; Subramaniam Kugathasan, Emory University
• Language: English
• Date: 2013-11-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: Copyright 2013 by ESPGHAN and NASPGHAN.
• Final Published Version (URL): http://dx.doi.org/10.1097/MPG.0b013e31829e0b89
• Title of Journal or Parent Work: Journal of Pediatric Gastroenterology and Nutrition
• ISSN: 0277-2116
• Volume: 57
• Issue: 5
• Start Page: 587
• End Page: 593
• Grant/Funding Information: This work was supported, in part, by grants from the National Institutes of Health: T32 DK007734 (to JAA); K23 AR054334 (to VT); K24 DK096574 (to TRZ); R01 DK 087694 (to SK); and UL1 TR000454 (Atlanta Clinical and Translational Science Institute).
• Keywords: AGE; Pediatrics; vitamin D; Life Sciences & Biomedicine; UNITED-STATES; HYPOVITAMINOSIS-D; Gastroenterology & Hepatology; WHITE-CHILDREN; INFLAMMATORY-BOWEL-DISEASE; IBD; YOUNG-ADULTS; HEALTH; BLACK; D DEFICIENCY; children; Nutrition & Dietetics; ADOLESCENTS; Crohn disease; Science & Technology; epidemiology
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Nutrition

Abstract

BACKGROUND:: Vitamin D deficiency and low bone mineral density (BMD) are complications of inflammatory bowel disease. Vitamin D deficiency is more prevalent among African Americans compared with whites. There are little data comparing differences in serum 25-hydroxyvitamin D (25OHD) concentrations and BMD between African American and white children with Crohn disease (CD). METHODS:: We compared serum 25OHD concentrations of African American children with CD (n=52) to white children with CD (n=64) and healthy African American controls (n=40). We also analyzed BMD using dual-energy x-ray absorptiometry results from our pediatric CD population. RESULTS:: African American children with CD had lower serum 25OHD concentrations (16.1 [95% confidence interval, CI 14.5-17.9] ng/mL) than whites with CD (22.3 [95% CI 20.2-24.6] ng/mL; P<0.001). African Americans with CD and controls exhibited similar serum 25OHD concentration (16.1 [95% CI 14.5-17.9] vs 16.3 [95% CI 14.4-18.4] ng/mL; NS). African Americans with CD exhibited no difference in serum 25OHD concentration when controlling for seasonality, disease severity, and surgical history, although serum 25OHD concentration was significantly decreased in overweight children (body mass index ≥85%, P=0.003). Multiple regression analysis demonstrated that obese African American girls with CD had the lowest serum 25OHD concentrations (9.6 [95% CI 6.8-13.5] ng/mL). BMD was comparable between African American and white children with CD (z score -0.4±0.9 vs -0.7±1.2; NS). CONCLUSIONS:: African American children with CD are more likely to have vitamin D deficiency compared with white children with CD, but have similar BMD. CD disease severity and history of surgery do not affect serum 25OHD concentrations among African American children with CD. African American children have low serum 25OHD concentrations, independent of CD, compared with white children. Future research should focus on how race affects vitamin D status and BMD in children with CD.