Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn's disease and intestinal resection

• Published in: The American journal of clinical nutrition Vol. 54; no. 3; pp. 548 - 552
• Main Authors: Leichtmann, GA, Bengoa, JM, Bolt, MJ, Sitrin, MD
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Elsevier Inc 01-09-1991; American Society for Clinical Nutrition
• Subjects: 25-hydroxycholecalciferol; absorcion digestiva; Absorption; absorption digestive; adulte; adultos; adults; Bile Acids and Salts - metabolism; bile salts; Biological and medical sciences; blood serum; Calcifediol - pharmacokinetics; Cholecalciferol; Cholecalciferol - pharmacokinetics; corps gras; Crohn Disease - metabolism; Crohn Disease - surgery; Crohn's disease; digestive absorption; Duodenum - metabolism; enfermedades intestinales; faeces; fats; feces; Gastroenterology. Liver. Pancreas. Abdomen; grasas; heces; Humans; intestinal absorption; intestinal diseases; intestinal resection; Intestines - metabolism; Intestines - surgery; malabsorption; maladie intestinale; Medical sciences; Osmolar Concentration; Other diseases. Semiology; Postoperative Period; reseccion; resection; sales biliares; sel biliaire; serum sanguin; short-bowel syndrome; steatorrhea; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; suero sanguineo; vitamin D; vitamina d; vitamine d; steatorrhea; 25-hydroxycholecalciferol; Cholecalciferol; vitamin D; malabsorption; Crohn's disease; intestinal absorption; bile salts; short-bowel syndrome; intestinal resection; Human; Resection; Vitamin; Short bowel syndrome; Crohn disease; Absorption; Intestinal malabsorption; Cholecalciferol(25-hydroxy); Digestive diseases; Complication; Intestinal disease; Malnutrition; Nutritional status
• ISSN: 0002-9165; 1938-3207
• DOI: 10.1093/ajcn/54.3.548

We compared the intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with Crohn's disease and resections of the small bowel. Patients were subgrouped into those with small (< 100 cm), intermediate (100–300 cm), and large (> 300 cm) resections. [3H]cholecalciferol or [3H]25-hydroxycholecalciferol were given orally and serial blood samples were taken for measurement of plasma radiolabeled vitamin. Absorption of both forms of the vitamin decreased with extent of resection but 25-hydroxycholecalciferol absorption was always greater than that of cholecalciferol. When compared with normal control subjects, 25-hydroxycholecalciferol absorption in these patients was better maintained than that of cholecalciferol. These data indicate that vitamin D malabsorption reflects the extent of distal small-bowel resection in Crohn's disease. Treatment with oral cholecalciferol is sufficient in those with small or moderate resections but oral 25-hydroxycholecalciferol supplementation may be preferred in those with a severe short-bowel syndrome.