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High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease

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Abstract

Summary

Vitamin K and D deficiency and decreased bone mineral density (BMD) were highly prevalent in patients with inflammatory bowel disease (IBD), especially Crohn’s disease (CD). Dietary intakes of these vitamins, however, were above the Japanese adequate intakes in IBD patients, suggesting that malabsorption is the basis for hypovitaminosis K and D and decreased BMD.

Introduction

We have studied the possible involvement of vitamin K and D deficiency in the pathogenesis of decreased BMD in IBD.

Methods

Seventy patients with IBD were evaluated for their BMD; plasma levels of vitamin K; phylloquinone (PK), menaquinone-7 (MK-7), and 25OH-D; serum PTH, protein induced by vitamin K absence (PIVKA-II), and undercarboxylated osteocalcin (ucOC) levels; and their food intake.

Results

Compared with ulcerative colitis (UC) patients, CD patients had significantly lower plasma vitamin K and 25OH-D concentrations; significantly higher serum levels of PTH, PIVKA-II, and ucOC; and significantly lower BMD scores at almost all measurement sites. More IBD patients were vitamin K deficient in bone than in liver. Multiple regression analyses revealed that low plasma concentrations of vitamin K and 25OH-D were independent risk factors for low BMD and that they were associated with the patients’ fat intake, but not with their intake of these vitamins.

Conclusion

IBD patients have high prevalence of decreased BMD and vitamin K and D deficiency probably caused by malabsorption of these vitamins.

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Acknowledgement

This study was supported by the Health and Labor Science Research Grant entitled “Studies on the Dietary Reference Intakes (Recommended Dietary Allowance) for Japanese” (principal investigator, Professor Katsumi Shibata, The University of Shiga Prefecture, Shiga, Japan) from the Ministry of Health, Labor and Welfare, Japan.

Conflicts of interest

None.

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Authors and Affiliations

  1. Department of Food and Nutrition, Kyoto Women’s University, 35, Imakumano-kitahiyoshicho, Higashiyama, Kyoto, 605-8501, Japan

    A. Kuwabara, K. Tanaka & S. Kido

  2. Department of Hygienic Sciences, Kobe Pharmaceutical University, Kobe, Japan

    N. Tsugawa, M. Kamao & T. Okano

  3. Department of Gastroenterology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    H. Nakase & T. Chiba

  4. Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    H. Tsuji, K. Shide & N. Inagaki

Authors
  1. A. Kuwabara
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  2. K. Tanaka
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  3. N. Tsugawa
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  4. H. Nakase
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  5. H. Tsuji
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  7. M. Kamao
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  10. T. Okano
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  11. S. Kido
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Correspondence to K. Tanaka.

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Kuwabara, A., Tanaka, K., Tsugawa, N. et al. High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease. Osteoporos Int 20, 935–942 (2009). https://doi.org/10.1007/s00198-008-0764-2

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  • DOI: https://doi.org/10.1007/s00198-008-0764-2

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