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United States Department of Agriculture

Agricultural Research Service

Research Project: ABSORPTION AND METABOLISM OF ESSENTIAL MINERAL NUTRIENTS IN CHILDREN Title: Vitamin D-mediated calcium absorption in patients with clinically stable Crohn's disease: a pilot study

Authors
item Kumari, Meena -
item Khazai, Natasha -
item Ziegler, Thomas -
item Nanes, Mark -
item Abrams, Steven -
item Tangpricha, Vin -

Submitted to: Molecular Nutrition and Food Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: October 19, 2009
Publication Date: August 1, 2010
Citation: Kumari, M., Khazai, N.B., Ziegler, T.R., Nanes, M.S., Abrams, S.A., Tangpricha, V. 2010. Vitamin D-mediated calcium absorption in patients with clinically stable Crohn's disease: a pilot study. Molecular Nutrition and Food Research. 54(8):1085-1091.

Interpretive Summary: Vitamin D is critical for intestinal absorption of calcium. Diseases associated with gut inflammation, such as Crohn’s disease (CD), may harm calcium absorption. This study evaluated calcium absorption in subjects with CD. Male subjects with CD (n = 4) and healthy age matched controls (n = 5) were studied. All subjects had fractional calcium absorption by the dual calcium isotope method. There was no significant difference in calcium absorption at baseline or after increasing doses of active vitamin D between the CD and controls. Our results suggest that CD patients have a normal response to vitamin D in enhancing the efficacy of calcium absorption. This suggests that stable CD patients can follow calcium and vitamin D guidelines of non-CD adults.

Technical Abstract: Vitamin D is the critical hormone for intestinal absorption of calcium. Optimal calcium absorption is important for proper mineralization of bone in the prevention of osteoporosis and osteoporotic fractures, among other important functions. Diseases associated with gut inflammation, such as Crohn's disease (CD), may impair calcium absorption. This pilot study evaluated vitamin D- dependent calcium absorption in subjects with CD. Male subjects with CD (n=4) and healthy age-matched controls (n=5) were studied. All subjects had fractional calcium absorption (FCA; by the dual calcium isotope method), serum 25-hydroxyvitamin D, serum calcium, and 24 h urinary calcium excretion measurements at baseline. The FCA in response to vitamin D therapy was re-assessed following administration of oral calcitriol 0.25 mcg twice daily for 1 wk, followed by oral calcitriol 0.50 mcg twice daily for 1 wk. Serum calcium and 24 h urinary calcium, determinations were re-assessed after each increasing dose of calcitriol as safety measures. There was no significant difference in calcium FCA at baseline or after increasing doses of calcitriol between the CD and controls. FCA in the control and CD group was approximately 35% at baseline, which increased to 60% after calcitriol therapy. No subject developed hypercalcemia or hypercalciuria. Our results suggest that CD patients have a normal response to vitamin D in enhancing the efficacy of calcium absorption. This suggests that stable CD patients can follow calcium and vitamin D guidelines of non-CD adults. Other factors independent of vitamin D status may impair intestinal calcium absorption in CD, including the degree and location of inflammation, presence of surgical resection and/or use of glucocorticoids.

Last Modified: 12/21/2014
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