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Vitamins A and E Serum Levels in Children and Young Adults with Inflammatory Bowel Disease: Effect of Disease Activity

Bousvaros, Athos; Zurakowski, David*; Duggan, Christopher; Law, Terry; Rifai, Nader; Goldberg, Nancy E.; Leichtner, Alan M.

Journal of Pediatric Gastroenterology and Nutrition: February 1998 - Volume 26 - Issue 2 - p 129-135
Original Articles

Background: Hypovitaminosis and fat-soluble vitamin deficiency have been reported in adults with inflammatory bowel disease (IBD). A prospective study was undertaken to determine the prevalence of low serum levels of vitamins A and E in children and young adults with IBD.

Methods: Clinical information and serum for vitamin levels was gathered prospectively from 61 patients with Crohn's disease, 36 patients with ulcerative colitis, and 23 control subjects. Disease activity and disease location were determined for IBD patients. Serum retinol and alpha-tocopherol levels were determined by high-performance liquid chromatography.

Results: The prevalence of hypovitaminosis A (defined as serum vitamin A <20μg/dl) or hypovitaminosis E (defined as serum vitamin E <5 mg/l) was 16% in the pediatric IBD population studied. Low vitamin A levels were more common than low vitamin E levels. Serum retinol levels correlated significantly with alpha-tocopherol levels. Hypovitaminosis was significantly more prevalent in the Crohn's disease patients who had active disease, an erythrocyte sedimentation rate of more than 25 mm/hour, or a serum albumin level less than 3 mg/dl.

Conclusions: Children and young adults with active IBD frequently have low serum levels of vitamin A or vitamin E. The severity of disease activity is a better predictor of risk for hypovitaminosis than is nutritional status. Further work is necessary to determine whether the hypovitaminosis seen in children with IBD reflects true deficiency.

Combined Program in Gastroenterology and Nutrition, * Department of Research Computing and Biostatistics, and†Division of Laboratory Medicine, Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.

Received September 23, 1996; revised April 29, 1997; accepted June 26, 1997.

Address correspondence and reprint requests to Dr. A. Bousvaros, GI Division, Hunnewell Building, Ground Floor, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, U.S.A.

© Lippincott-Raven Publishers