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  • 1 Semmelweis Egyetem, Általános Orvostudományi Kar II. Belgyógyászati Klinika Budapest Szentkirályi u. 46. 1088
  • 2 Semmelweis Egyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Budapest
  • 3 Tolna Megyei Balassa János Kórház Gasztroenterológiai Osztály Szekszárd
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Bevezetés: A D-vitamin nemcsak a kalciumháztartásban játszik fontos szerepet, hanem immunológiai és sejtanyagcserét befolyásoló hatásokkal is bír. Gyulladásos bélbetegekben gyakrabban fordul elő D-vitamin-hiány, erről azonban hazai adat nem áll rendelkezésre. Célkitűzés: A szerzők gyulladásos bélbetegségben szenvedő betegek D-vitamin-szintjének felmérését tűzték ki célul. Módszer: 169 betegben az alapbetegség aktivitását, a csontanyagcserére vonatkozó laboratóriumi paramétereket és a D-vitamin szérumszintjét határozták meg. Eredmények: A betegek átlag-D-vitamin-szérumszintje 22,7±10,6 ng/ml volt. A betegek 20%-ában volt megfelelő a D-vitamin-ellátottság (>30 ng/ml), 52%-uknál D-vitamin-hiány (15–30 ng/ml), 28%-ánál pedig súlyos (<15 ng/ml) D-hipovitaminózis volt igazolható. Nem volt korreláció sem a klinikai aktivitási indexek (parciális Mayo-score: –0,143; Crohn-betegség-aktivitási index: –0,253), sem a laboratóriumi gyulladásos paraméterek (C-reaktív fehérje: r = 0,008; süllyedés: r = 0,012) és a D-vitamin-szint között. Következtetések: Gyulladásos bélbetegek D-vitamin-ellátottsága nem megfelelő. Bár a klinikai aktivitás és a D-vitamin-szint között nem találtak összefüggést, ajánlott a D-vitamin-szérumszint ellenőrzése, és szükség esetén pótlása. Orv. Hetil., 2013, 154(46), 1821–1828.

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  • Holick, M. F.: Vitamin D: A millenium perspective. J. Cell. Biochem., 2003, 88, 296–307.

    Holick M. F. , 'Vitamin D: A millenium perspective ' (2003 ) 88 J. Cell. Biochem. : 296 -307.

  • Liu, M., Lee, M. H., Cohen, M., et al.: Transcriptional activation of the Cdk inhibitor p21 by vitamin D3 leads to the induced differentiation of the myelomonocytic cell line U937. Genes Dev., 1996, 10, 142–153.

    Cohen M. , 'Transcriptional activation of the Cdk inhibitor p21 by vitamin D3 leads to the induced differentiation of the myelomonocytic cell line U937 ' (1996 ) 10 Genes Dev. : 142 -153.

    • Search Google Scholar
  • Christakos, S., Friedlander, E. J., Frandsen, B. R., et al.: Studies on the mode of action of calciferol. XIII. Development of a radioimmunoassay for vitamin D-dependent chick intestinal calcium-binding protein and tissue distribution. Endocrinology, 1979, 104, 1495–1503.

    Frandsen B. R. , 'Studies on the mode of action of calciferol. XIII. Development of a radioimmunoassay for vitamin D-dependent chick intestinal calcium-binding protein and tissue distribution ' (1979 ) 104 Endocrinology : 1495 -1503.

    • Search Google Scholar
  • Li, Y. C., Kong, J., Wei, M., et al.: 1,25-dihydroxyvitamin D3 is a negative endocrine regulator of the renin-angiotensin system. J. Clin. Invest., 2002, 110, 229–238.

    Wei M. , '1,25-dihydroxyvitamin D3 is a negative endocrine regulator of the renin-angiotensin system ' (2002 ) 110 J. Clin. Invest. : 229 -238.

    • Search Google Scholar
  • Favus, M. J. (ed.): Primer on the metabolic bone diseases and disorders of mineral metabolism. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins, 2003. Washington, D. C.: American Society for Bone and Mineral Research. 15:567.

    '', in Primer on the metabolic bone diseases and disorders of mineral metabolism , (2003 ) -.

    • Search Google Scholar
  • Nagpal, S., Na, S., Rathnachalam, R.: Noncalcemic actions of vitamin D receptor ligands. Endocr. Rev., 2005, 26, 662–687.

    Rathnachalam R. , 'Noncalcemic actions of vitamin D receptor ligands ' (2005 ) 26 Endocr. Rev. : 662 -687.

    • Search Google Scholar
  • Shikari, M., Kushida, K., Yamazaki, K., et al.: Effects of 2 years’ treatment of osteoporosis with 1 alpha-hydroxy vitamin D3 on bone mineral density and incidence of fracture: a placebo-controlled, double-blind prospective study. Endocr. J., 1996, 43, 211–220.

    Yamazaki K. , 'Effects of 2 years’ treatment of osteoporosis with 1 alpha-hydroxy vitamin D3 on bone mineral density and incidence of fracture: a placebo-controlled, double-blind prospective study ' (1996 ) 43 Endocr. J. : 211 -220.

    • Search Google Scholar
  • Broe, K. E., Chen, T. C., Weinberg, J., et al.: A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J. Am. Geriatr. Soc., 2007, 55, 234–239.

    Weinberg J. , 'A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study ' (2007 ) 55 J. Am. Geriatr. Soc. : 234 -239.

    • Search Google Scholar
  • Dukas, L., Schacht, E., Runge, M., et al.: Effect of a six-month therapy with alfacalcidol on muscle power and balance and the number of fallers and falls. Arzneimittel-Forschung, 2010, 60, 519–525.

    Runge M. , 'Effect of a six-month therapy with alfacalcidol on muscle power and balance and the number of fallers and falls ' (2010 ) 60 Arzneimittel-Forschung : 519 -525.

    • Search Google Scholar
  • Li, P., Li, C., Zhao, X., et al.: p27Kip1 stabilization and G1 arrest by 1,25-dihydroxyvitamin D3 in ovarian cancer cells mediated through down-regulation of cyclin E/cyclin-dependent kinase 2 and Skp1-Cullin-F-box protein/Skp2 ubiquitin ligase. J. Biol. Chem., 2004, 279, 25260–25267.

    Zhao X. , 'p27Kip1 stabilization and G1 arrest by 1,25-dihydroxyvitamin D3 in ovarian cancer cells mediated through down-regulation of cyclin E/cyclin-dependent kinase 2 and Skp1-Cullin-F-box protein/Skp2 ubiquitin ligase ' (2004 ) 279 J. Biol. Chem. : 25260 -25267.

    • Search Google Scholar
  • Zittermann, A.: Vitamin D in preventive medicine: are we ignoring the evidence? Br. J. Nutr., 2003, 89, 552–572.

    Zittermann A. , 'Vitamin D in preventive medicine: are we ignoring the evidence? ' (2003 ) 89 Br. J. Nutr. : 552 -572.

    • Search Google Scholar
  • Garland, C. F., Comstock, G. W., Garland, F. C., et al.: Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study. Lancet, 1989, 334, 1176–1178.

    Garland F. C. , 'Serum 25-hydroxyvitamin D and colon cancer: eight-year prospective study ' (1989 ) 334 Lancet : 1176 -1178.

    • Search Google Scholar
  • Mathieu, C., Adorini, L.: The coming of age of 1,25-dihydroxyvitamin D3 analogs as immunomodulatory agents. Trends Mol. Med., 2002, 8, 174–179.

    Adorini L. , 'The coming of age of 1,25-dihydroxyvitamin D3 analogs as immunomodulatory agents ' (2002 ) 8 Trends Mol. Med. : 174 -179.

    • Search Google Scholar
  • Lemire, J. M., Adams, J. S.: 1,25-dihydroxyvitamin D3 inhibits the passive transfer of cellular immunity by a myelin basic protein-specific T cell clone. J. Bone Miner. Res., 1992, 7, 171–177.

    Adams J. S. , '1,25-dihydroxyvitamin D3 inhibits the passive transfer of cellular immunity by a myelin basic protein-specific T cell clone ' (1992 ) 7 J. Bone Miner. Res. : 171 -177.

    • Search Google Scholar
  • Chang, C. C., Ciubotariu, R., Manavalan, J. S., et al.: Tolerization of dendritic cells by TS cells: the crucial role of inhibitory receptors ILT3 and ILT4. Nat. Immunol., 2002, 3, 237–243.

    Manavalan J. S. , 'Tolerization of dendritic cells by TS cells: the crucial role of inhibitory receptors ILT3 and ILT4 ' (2002 ) 3 Nat. Immunol. : 237 -243.

    • Search Google Scholar
  • Holick, M. F.: Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. Am. J. Clin. Nutr., 2004, 79, 362–371.

    Holick M. F. , 'Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis ' (2004 ) 79 Am. J. Clin. Nutr. : 362 -371.

    • Search Google Scholar
  • Cantorna, M. T., Munsick, C., Bemiss, C., et al.: 1,25-dihydroxycholecalciferol prevents and ameliorates symptoms of experimental murine inflammatory bowel disease. J. Nutr., 2000, 130, 2648–2652.

    Bemiss C. , '1,25-dihydroxycholecalciferol prevents and ameliorates symptoms of experimental murine inflammatory bowel disease ' (2000 ) 130 J. Nutr. : 2648 -2652.

    • Search Google Scholar
  • Cantorna, M. T., Hayes, C. E., DeLuca, H. F.: 1,25-dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis. J. Nutr., 1998, 128, 68–72.

    DeLuca H. F. , '1,25-dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis ' (1998 ) 128 J. Nutr. : 68 -72.

    • Search Google Scholar
  • Yuk, J. M., Shin, D. M., Lee, H. M., et al.: Vitamin D3 induces autophagy in human monocytes/macrophages via cathelicidin. Cell Host Microbe, 2009, 6, 231–243.

    Lee H. M. , 'Vitamin D3 induces autophagy in human monocytes/macrophages via cathelicidin ' (2009 ) 6 Cell Host Microbe : 231 -243.

    • Search Google Scholar
  • Schauber, J., Rieger, D., Weiler, F., et al.: Heterogeneous expression of human cathelicidin hCAP18/LL-37 in inflammatory bowel diseases. Eur. J. Gastroenterol. Hepatol., 2006, 18, 615–621.

    Weiler F. , 'Heterogeneous expression of human cathelicidin hCAP18/LL-37 in inflammatory bowel diseases ' (2006 ) 18 Eur. J. Gastroenterol. Hepatol. : 615 -621.

    • Search Google Scholar
  • Kühn, R., Löhler, J., Rennick, D., et al.: Interleukin-10-deficient mice develop chronic enterocolitis. Cell, 1993, 75, 263–274.

    Rennick D. , 'Interleukin-10-deficient mice develop chronic enterocolitis ' (1993 ) 75 Cell : 263 -274.

    • Search Google Scholar
  • MacDonald, T. T.: Gastrointestinal inflammation. Inflammatory bowel disease in knockout mice. Curr. Biol., 1994, 4, 261–263.

    MacDonald T. T. , 'Gastrointestinal inflammation. Inflammatory bowel disease in knockout mice ' (1994 ) 4 Curr. Biol. : 261 -263.

    • Search Google Scholar
  • Wada, K., Tanaka, H., Maeda, K., et al.: Vitamin D receptor expression is associated with colon cancer in ulcerative colitis. Oncol. Rep., 2009, 22, 1021–1025.

    Maeda K. , 'Vitamin D receptor expression is associated with colon cancer in ulcerative colitis ' (2009 ) 22 Oncol. Rep. : 1021 -1025.

    • Search Google Scholar
  • Siffledeen, J. S., Siminoski, K., Steinhart, H., et al.: The frequency of vitamin D deficiency in adults with Crohn’s disease. Can. J. Gastroenterol., 2003, 17, 473–478.

    Steinhart H. , 'The frequency of vitamin D deficiency in adults with Crohn’s disease ' (2003 ) 17 Can. J. Gastroenterol. : 473 -478.

    • Search Google Scholar
  • Tajika, M., Matsuura, A., Nakamura, T., et al.: Risk factors for vitamin D deficiency in patients with Crohn’s disease. J. Gastroenterol., 2004, 39, 527–533.

    Nakamura T. , 'Risk factors for vitamin D deficiency in patients with Crohn’s disease ' (2004 ) 39 J. Gastroenterol. : 527 -533.

    • Search Google Scholar
  • Jahnsen, J., Falch, J. A., Mowinckel, P., et al.: Vitamin D status, parathyroid hormone and bone mineral density in patients with inflammatory bowel disease. Scand. J. Gastroenterol., 2002, 37, 192–199.

    Mowinckel P. , 'Vitamin D status, parathyroid hormone and bone mineral density in patients with inflammatory bowel disease ' (2002 ) 37 Scand. J. Gastroenterol. : 192 -199.

    • Search Google Scholar
  • Lennard-Jones, J. E.: Classification of inflammatory bowel disease. Scand. J. Gastroenterol., 1989, 170, (Suppl), 2–6.

    Lennard-Jones J. E. , 'Classification of inflammatory bowel disease ' (1989 ) 170 Scand. J. Gastroenterol. : (Suppl), 2 -6.

    • Search Google Scholar
  • Satsangi, J., Silverberg, M. S., Vermeire, S., et al.: The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut, 2006, 55, 749–753.

    Vermeire S. , 'The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications ' (2006 ) 55 Gut : 749 -753.

    • Search Google Scholar
  • Godfrey, K.: Implementation of the Malnutrition Universal Screening Tool. Nurs. Times, 2004, 100, 61.

    Godfrey K. , 'Implementation of the Malnutrition Universal Screening Tool ' (2004 ) 100 Nurs. Times : 61 -.

    • Search Google Scholar
  • Shivananda, S., Lennard-Jones, J., Logan, R., et al.: Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). Gut, 1996, 39, 690–697.

    Logan R. , 'Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD) ' (1996 ) 39 Gut : 690 -697.

    • Search Google Scholar
  • Zeng, L., Anderson, F. H.: Seasonal change in the exacerbations of Crohn’s disease. Scand. J. Gastroenterol., 1996, 31, 79–82.

    Anderson F. H. , 'Seasonal change in the exacerbations of Crohn’s disease ' (1996 ) 31 Scand. J. Gastroenterol. : 79 -82.

    • Search Google Scholar
  • Moum, B., Aadland, E., Ekbom, A., et al.: Seasonal variations in the onset of ulcerative colitis. Gut, 1996, 38, 376–378.

    Ekbom A. , 'Seasonal variations in the onset of ulcerative colitis ' (1996 ) 38 Gut : 376 -378.

    • Search Google Scholar
  • O’Sullivan, M., O’Morain, C.: Nutrition in inflammatory bowel disease. Best Pract. Res. Clin. Gastroenterol., 2006, 20, 561–573.

    O’Morain C. , 'Nutrition in inflammatory bowel disease ' (2006 ) 20 Best Pract. Res. Clin. Gastroenterol. : 561 -573.

    • Search Google Scholar
  • Cabré, E., Gassull, M. A.: Nutritional and metabolic issues in inflammatory bowel disease. Curr. Opin. Clin. Nutr. Metab. Care, 2003, 6, 569–576.

    Gassull M. A. , 'Nutritional and metabolic issues in inflammatory bowel disease ' (2003 ) 6 Curr. Opin. Clin. Nutr. Metab. Care : 569 -576.

    • Search Google Scholar
  • Abitbol, V., Roux, C., Guillemant, S., et al.: Bone assessment in patients with ileal pouch-anal anastomosis for inflammatory bowel disease. Br. J. Surg., 1997, 84, 1551–1554.

    Guillemant S. , 'Bone assessment in patients with ileal pouch-anal anastomosis for inflammatory bowel disease ' (1997 ) 84 Br. J. Surg. : 1551 -1554.

    • Search Google Scholar
  • Ardizzone, S., Bollani, S., Bettica, P., et al.: Altered bone metabolism in inflammatory bowel disease: there is a difference between Crohn’s disease and ulcerative colitis. J. Intern. Med., 2000, 247, 63–70.

    Bettica P. , 'Altered bone metabolism in inflammatory bowel disease: there is a difference between Crohn’s disease and ulcerative colitis ' (2000 ) 247 J. Intern. Med. : 63 -70.

    • Search Google Scholar
  • Silvennoinen, J.: Relationships between vitamin D, parathyroid hormone and bone mineral density in inflammatory bowel disease. J. Intern. Med., 1996, 239, 131–137.

    Silvennoinen J. , 'Relationships between vitamin D, parathyroid hormone and bone mineral density in inflammatory bowel disease ' (1996 ) 239 J. Intern. Med. : 131 -137.

    • Search Google Scholar
  • Bischoff-Ferrari, H. A., Dietrich, T., Orav, E. J., et al.: Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am. J. Med., 2004, 116, 634–639.

    Orav E. J. , 'Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults ' (2004 ) 116 Am. J. Med. : 634 -639.

    • Search Google Scholar
  • Pappa, H. M., Gordon, C. M., Saslowsky, T. M., et al.: Vitamin D status in children and young adults with inflammatory bowel disease. Pediatrics, 2006, 118, 1950–1961.

    Saslowsky T. M. , 'Vitamin D status in children and young adults with inflammatory bowel disease ' (2006 ) 118 Pediatrics : 1950 -1961.

    • Search Google Scholar
  • Vogelsang, H., Ferenci, P., Resch, H., et al.: Prevention of bone mineral loss in patients with Crohn’s disease by long-term oral vitamin D supplementation. Eur. J. Gastroenterol. Hepatol., 1995, 7, 609–614.

    Resch H. , 'Prevention of bone mineral loss in patients with Crohn’s disease by long-term oral vitamin D supplementation ' (1995 ) 7 Eur. J. Gastroenterol. Hepatol. : 609 -614.

    • Search Google Scholar
  • Bernstein, C. N., Seeger, L. L., Anton, P. A., et al.: A randomized, placebo-controlled trial of calcium supplementation for decreased bone density in corticosteroid-using patients with inflammatory bowel disease: a pilot study. Aliment. Pharmacol. Ther., 1996, 10, 777–786.

    Anton P. A. , 'A randomized, placebo-controlled trial of calcium supplementation for decreased bone density in corticosteroid-using patients with inflammatory bowel disease: a pilot study ' (1996 ) 10 Aliment. Pharmacol. Ther. : 777 -786.

    • Search Google Scholar
  • Miheller, P., Muzes, G., Hritz, I., et al.: Comparison of the effects of 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D on bone pathology and disease activity in Crohn’s disease patients. Inflamm. Bowel Dis., 2009, 15, 1656–1662.

    Hritz I. , 'Comparison of the effects of 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D on bone pathology and disease activity in Crohn’s disease patients ' (2009 ) 15 Inflamm. Bowel Dis. : 1656 -1662.

    • Search Google Scholar
  • Leichtmann, G. A., Bengoa, J. M., Bolt, M. J., et al.: Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn’s disease and intestinal resection. Am. J. Clin. Nutr., 1991, 54, 548–552.

    Bolt M. J. , 'Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn’s disease and intestinal resection ' (1991 ) 54 Am. J. Clin. Nutr. : 548 -552.

    • Search Google Scholar
  • Thomas, M. K., Lloyd-Jones, D. M., Thadhani, R. I., et al.: Hypovitaminosis D in medical inpatients. N. Engl. J. Med., 1998, 338, 777–783.

    Thadhani R. I. , 'Hypovitaminosis D in medical inpatients ' (1998 ) 338 N. Engl. J. Med. : 777 -783.

    • Search Google Scholar
  • Holick, M. F.: Vitamin D deficiency. N. Engl. J. Med., 2007, 357, 266–281.

    Holick M. F. , 'Vitamin D deficiency ' (2007 ) 357 N. Engl. J. Med. : 266 -281.

  • Holick, M. F., Binkley, N. C., Bischoff-Ferrari, H. A., et al.: Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab., 2011, 96, 1911–1930.

    Bischoff-Ferrari H. A. , 'Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline ' (2011 ) 96 J. Clin. Endocrinol. Metab. : 1911 -1930.

    • Search Google Scholar
  • Hwang, C., Ross, V., Mahadevan, U.: Micronutrient deficiencies in inflammatory bowel disease: from A to zinc. Inflamm. Bowel Dis., 2012, 18, 1961–1981.

    Mahadevan U. , 'Micronutrient deficiencies in inflammatory bowel disease: from A to zinc ' (2012 ) 18 Inflamm. Bowel Dis. : 1961 -1981.

    • Search Google Scholar
  • Takács, I., Benkő, I., Toldy, E., et al.: Hungarian consensus regarding the role of vitamin D in the prevention and treatment of diseases. [Hazai konszenzus a D-vitamin szerepéről a betegségek megelőzésében és kezelésében.] Orv. Hetil., 2012, 153 (Suppl.), 5–26. [Hungarian]

    Toldy E. , 'Hungarian consensus regarding the role of vitamin D in the prevention and treatment of diseases. [Hazai konszenzus a D-vitamin szerepéről a betegségek megelőzésében és kezelésében.] ' (2012 ) 153 Orv. Hetil. : 5 -26.

    • Search Google Scholar

 

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