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The Prevalence of Vitamin D Insufficiency and Deficiency and Their Relationship with Bone Mineral Density and Fracture Risk in Adults Receiving Long-Term Home Parenteral Nutrition

1
Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
2
Nutrition Services, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
*
Author to whom correspondence should be addressed.
Nutrients 2017, 9(5), 481; https://doi.org/10.3390/nu9050481
Received: 7 March 2017 / Revised: 20 April 2017 / Accepted: 5 May 2017 / Published: 10 May 2017
(This article belongs to the Special Issue Parenteral Nutrition 2016)
It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral density (BMD) and fracture risk in long-term HPN patients. Methods: A retrospective chart review of all 186 patients in the HPN registry followed by the Northern Alberta Home Parenteral Nutrition Program receiving HPN therapy >6 months with a 25 (OH) D level and BMD reported were studied. Results: The mean age at the initiation of HPN was 53.8 (20–79) years and 23 (37%) were male. The mean HPN duration was 56 (6–323) months and the most common diagnosis was short bowel syndrome. Based on a total of 186 patients, 62 patients were categorized based on serum vitamin D status as follows: 1 (24.2%) sufficient, 31 (50%) insufficient and 16 (25.8%) deficient. Despite an average of 1891 IU/day orally and 181 IU/day intravenously vitamin D, the mean vitamin D level was 25.6 ng/mL (insufficiency) and 26.2 ± 11.9 ng/mL in patients with the highest 10-year fracture risk. Conclusion: Suboptimal vitamin D levels are common among patients on long-term HPN despite nutrient intake that should meet requirements. View Full-Text
Keywords: home parenteral nutrition; vitamin D; vitamin D insufficiency; vitamin D deficiency; bone mineral density; fracture home parenteral nutrition; vitamin D; vitamin D insufficiency; vitamin D deficiency; bone mineral density; fracture
MDPI and ACS Style

Napartivaumnuay, N.; Gramlich, L. The Prevalence of Vitamin D Insufficiency and Deficiency and Their Relationship with Bone Mineral Density and Fracture Risk in Adults Receiving Long-Term Home Parenteral Nutrition. Nutrients 2017, 9, 481.

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