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Risk Factors for Vitamin D, Zinc, and Selenium Deficiencies in Korean Patients with Inflammatory Bowel Disease

김나영|성미경|김주성|박영수|이동호|윤혁|신철민|임수|한유민
거트앤리버 소화기연관학회협의회|2017.05|Gut and Liver|제11권 제3호|pp. 363-369

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Vitamin DZincSeleniumInflammatory bowel diseasesDeficiency

초록

Background/Aims: Studies on the micronutrient status of Asian patients with inflammatory bowel disease (IBD) are scarce. We evaluated the prevalence of micronutrient deficiency and verified the risk factors for micronutrient deficiency in Korean patients with IBD. Methods: We measured the serum levels of 25-hydroxyvitamin D3 [25-(OH)D], zinc, and selenium to analyze the clinical risk factors for micronutrient levels below the reference values. In addition, we compared the 25-(OH)D levels of patients with IBD to those of age- and sex-matched healthy controls. Results: Among the 83 patients, 74 (89.2%) had suboptimal serum 25-(OH)D levels. The mean plasma 25-(OH)D level in patients with IBD was significantly reduced compared to that of the healthy controls (12.3±6.2 ng/mL vs 20.0±6.7 ng/mL; p<0.001). The proportions of patients with lower serum zinc and selenium levels were 39.0% and 30.9%, respectively. Female sex (p=0.012) and Crohn’s disease (p=0.012) were associated with vitamin D deficiency. Patients younger than 40 years were at increased risk for zinc deficiency (p=0.045). Female sex (p=0.015) and low serum albumin level (<3.3 g/dL) (p=0.047) were risk factors for selenium deficiency. Conclusions: Many Korean patients with IBD have vitamin D, zinc, and selenium deficiencies, suggesting the necessity for monitoring levels of these micronutrients.

Abstract

Background/Aims: Studies on the micronutrient status of Asian patients with inflammatory bowel disease (IBD) are scarce. We evaluated the prevalence of micronutrient deficiency and verified the risk factors for micronutrient deficiency in Korean patients with IBD. Methods: We measured the serum levels of 25-hydroxyvitamin D3 [25-(OH)D], zinc, and selenium to analyze the clinical risk factors for micronutrient levels below the reference values. In addition, we compared the 25-(OH)D levels of patients with IBD to those of age- and sex-matched healthy controls. Results: Among the 83 patients, 74 (89.2%) had suboptimal serum 25-(OH)D levels. The mean plasma 25-(OH)D level in patients with IBD was significantly reduced compared to that of the healthy controls (12.3±6.2 ng/mL vs 20.0±6.7 ng/mL; p<0.001). The proportions of patients with lower serum zinc and selenium levels were 39.0% and 30.9%, respectively. Female sex (p=0.012) and Crohn’s disease (p=0.012) were associated with vitamin D deficiency. Patients younger than 40 years were at increased risk for zinc deficiency (p=0.045). Female sex (p=0.015) and low serum albumin level (<3.3 g/dL) (p=0.047) were risk factors for selenium deficiency. Conclusions: Many Korean patients with IBD have vitamin D, zinc, and selenium deficiencies, suggesting the necessity for monitoring levels of these micronutrients.

참고문헌 (48)

  1. Mekhjian HS, "Clinical features and natural history of Crohn’s disease", Gastroenterology, 77(4 Pt 2), pp.898~906 (1979)
  2. Weisshof R, "Micronutrient deficiencies in inflammatory bowel disease", Curr Opin Clin Nutr Metab Care, 18, pp.576~581 (2015)
  3. Harries AD, "Nutritional disturbances in Crohn’s disease", Postgrad Med J, 59, pp.690~697 (1983)
  4. Dawson AM, "Nutritional disturbances in Crohn’s disease", Br J Surg, 59, pp.817~819 (1972)
  5. Filippi J, "Nutritional deficiencies in patients with Crohn’s disease in remission", Inflamm Bowel Dis, 12, pp.185~191 (2006)
  6. Hwang C, "Micronutrient deficiencies in inflammatory bowel disease: from A to zinc", Inflamm Bowel Dis, 18, pp.1961~1981 (2012)
  7. Massironi S, "Nutritional deficiencies in inflammatory bowel disease: therapeutic approaches", Clin Nutr, 32, pp.904~910 (2013)
  8. So Yoon Yoon, "Nutritional Support in Patients with Inflammatory Bowel Diseases", Intestinal research, 11(4), pp.243~249 (2013), 대한장연구학회
  9. Holick MF, "Vitamin D deficiency", N Engl J Med, 357, pp.266~281 (2007)
  10. Siffledeen JS, "The frequency of vitamin D deficiency in adults with Crohn’s disease", Can J Gastroenterol, 17, pp.473~478 (2003)
  11. Sentongo TA, "Vitamin D status in children, adolescents, and young adults with Crohn disease", Am J Clin Nutr, 76, pp.1077~1081 (2002)
  12. Leslie WD, "Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD cohort study", Am J Gastroenterol, 103, pp.1451~1459 (2006)
  13. Gilman J, "Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use", Eur J Clin Nutr, 60, pp.889~896 (2006)
  14. Li YC, "Critical roles of intestinal epithelial vitamin D receptor signaling in controlling gut mucosal inflammation", J Steroid Biochem Mol Biol, 148, pp.179~183 (2015)
  15. Ooi JH, "Vitamin D regulates the gut microbiome and protects mice from dextran sodium sulfateinduced colitis", J Nutr, 143, pp.1679~1686 (2013)
  16. Livingstone C, "Zinc: physiology, deficiency, and parenteral nutrition", Nutr Clin Pract, 30, pp.371~382 (2015)
  17. Vagianos K, "Nutrition assessment of patients with inflammatory bowel disease", JPEN J Parenter Enteral Nutr, 31, pp.311~319 (2007)
  18. Wong CP, "Zinc deficiency enhanced inflammatory response by increasing immune cell activation and inducing IL6 promoter demethylation", Mol Nutr Food Res, 59, pp.991~999 (2015)
  19. Stoffaneller R, "A review of dietary selenium intake and selenium status in Europe and the Middle East", Nutrients, 7, pp.1494~1537 (2015)
  20. Reimund JM, "Antioxidant and immune status in active Crohn’s disease: a possible relationship", Clin Nutr, 19, pp.43~48 (2000)
  21. Barrett CW, "Dietary selenium deficiency exacerbates DSS-induced epithelial injury and AOM", DSS-induced tumorigenesis, 2013, pp.8, e67845~
  22. Barnett M, "Investigating micronutrients and epigenetic mechanisms in relation to inflammatory bowel disease", Mutat Res, 690, pp.71~80 (2010)
  23. Ulitsky A, "Vitamin D deficiency in patients with inflammatory bowel disease: association with disease activity and quality of life", JPEN J Parenter Enteral Nutr, 35, pp.308~316 (2011)
  24. Fu YT, "Hypovitaminosis D in adults with inflammatory bowel disease: potential role of ethnicity", Dig Dis Sci, 57, pp.2144~2148 (2012)
  25. Holick MF, "25-OH-vitamin D assays", J Clin Endocrinol Metab, 90, pp.3128~3129 (2005)
  26. Rosen CJ, "Clinical practice: vitamin D insufficiency", N Engl J Med, 364, pp.248~254 (2011)
  27. Lim S, "Association of vitamin D deficiency with incidence of type 2 diabetes in high-risk Asian subjects", Am J Clin Nutr, 97, pp.524~530 (2013)
  28. Ananthakrishnan AN, "Normalization of plasma 25-hydroxy vitamin D is associated with reduced risk of surgery in Crohn’s disease", Inflamm Bowel Dis, 19, pp.1921~1927 (2013)
  29. 최한석, "Vitamin D Status in Korea", Endocrinology and Metabolism, 28(1), pp.12~16 (2013), 대한내분비학회
  30. Shin YH, "High prevalence of vitamin D insufficiency or deficiency in young adolescents in Korea", Eur J Pediatr, 171, pp.1475~1480 (2012)
  31. Kuwabara A, "High prevalence of vitamin K and D deficiency and decreased BMD in inflammatory bowel disease", Osteoporos Int, 20, pp.935~942 (2009)
  32. Jahnsen J, "Vitamin D status, parathyroid hormone and bone mineral density in patients with inflammatory bowel disease", Scand J Gastroenterol, 37, pp.192~199 (2002)
  33. Joseph AJ, "25 (OH) vitamin D level in Crohn’s disease: association with sun exposure & disease activity", Indian J Med Res, 130, pp.133~137 (2009)
  34. Lee YC, "A study on serum concentrations of antioxidant minerals in normal Korean adults", Korean J Nutr, 31, pp.324~332 (1998)
  35. 최재혁, "Old Age at Diagnosis Is Associated With Favorable Outcomes in Korean Patients With Inflammatory Bowel Disease", Intestinal research, 13(1), pp.60~67 (2015), 대한장연구학회[DOI]
  36. Romberg-Camps MJ, "Influence of phenotype at diagnosis and of other potential prognostic factors on the course of inflammatory bowel disease", Am J Gastroenterol, 104, pp.371~383 (2009)
  37. Santucci NR, "Vitamin and zinc status pretreatment and posttreatment in patients with inflammatory bowel disease", J Pediatr Gastroenterol Nutr, 59, pp.455~457 (2014)
  38. Kim YJ, "Serum selenium level in healthy Koreans", Biol Trace Elem Res, 131, pp.103~109 (2009)
  39. Van Cauwenbergh R, "Selenium concentration in serum of healthy Greek adults", J Trace Elem Electrolytes Health Dis, 8, pp.99~109 (1994)
  40. Dubois F, "Common values of serum selenium in a population in Eastern France", Ann Biol Clin (Paris), 48, pp.28~32 (1990)
  41. Wang J, "Distribution and translocation of selenium from soil to highland barley in the Tibetan Plateau Kashin- Beck disease area", Environ Geochem Health, 39, pp.221~229 (2017)
  42. Sunde RA, "Longitudinal selenium status in healthy British adults: assessment using biochemical and molecular biomarkers", Br J Nutr, 99(Suppl 3), pp.S37~S47 (2008)
  43. Galan P, "Serum concentrations of betacarotene, vitamins C and E, zinc and selenium are influenced by sex, age, diet, smoking status, alcohol consumption and corpulence in a general French adult population", Eur J Clin Nutr, 59, pp.1181~1190 (2005)
  44. Błażewicz A, "Serum and urinary selenium levels in obese children: a cross-sectional study", J Trace Elem Med Biol, 29, pp.116~122 (2015)
  45. Rannem T, "Selenium status in patients with Crohn’s disease", Am J Clin Nutr, 56, pp.933~937 (1992)
  46. Fairweather-Tait SJ, "Selenium in human health and disease", Antioxid Redox Signal, 14, pp.1337~1383 (2011)
  47. Wong Zhiqin, "Inflammatory Bowel Disease-related Colorectal Cancer in the Asia-Pacific Region: Past, Present, and Future", Intestinal research, 12(3), pp.194~204 (2014), 대한장연구학회
  48. Krehl S, "Glutathione peroxidase-2 and selenium decreased inflammation and tumors in a mouse model of inflammation-associated carcinogenesis whereas sulforaphane effects differed with selenium supply", Carcinogenesis, 33, pp.620~628 (2012)

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