Are Vitamin D Levels Related to Sarcopenia in Children with Inflammatory Bowel Disease?

Background

Data on the impacts of vitamin D deficiency on sarcopenia in pediatric patients with inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are lacking. We aimed to investigate the relationships between vitamin D levels and sarcopenia in patients with newly diagnosed IBD.

Methods

A cross-sectional, retrospective study was conducted in a tertiary care children's hospital. Pediatric IBD patients who underwent magnetic resonance (MR) enteroclysis at the time of initial diagnosis were included. Total psoas muscle area (tPMA) at the L4/L5 intervertebral level was demonstrated on MR by scanning the right and left psoas muscle areas. Sarcopenia was defined as a measurement under the 10th percentile according to MR-derived reference values of tPMA percentile charts for healthy children aged 1-18 years. Vitamin D insufficiency was defined as a serum 25-OH-D level below 30 ng/mL and deficiency as that below 20 ng/mL. Collected data from demographic evaluation, clinic, and laboratory tests were statistically assessed.

Results

According to the MR-derived reference values of tPMA, 85% (n = 33) of UC and 81% (n = 21) of CD patients had sarcopenia. The severe vitamin D deficiency ratio was 35.9% (n = 14) in UC and 38.5% (n = 10) in CD. We found that vitamin D levels were similar in patients with UC and CD, while they were significantly lower in the group below the 3rd percentile of tPMA (n = 41, median 9.8) than in the group between the 3rd and 10th percentiles (n = 13, median 16.9; p = 0.038).

Conclusions

Formulating strategies to recognize and prevent sarcopenia, including the prevention and-if necessary-the treatment of vitamin D deficiency, could bring multi-faceted benefits.