Seasonal variability of vitamin D and bone metabolism in infliximab-treated paediatric Crohn's disease.
BACKGROUND
Paediatric Crohn's disease patients suffer from several complications, including low bone mineral density and inadequate serum levels of 25-hydroxy vitamin D.


AIMS
The aim of this prospective study was to address the effect of infliximab therapy on bone metabolism, bone mineral density and vitamin D homeostasis. The seasonal variability of serum vitamin D levels in relation to infliximab treatment was also analysed.


METHODS
Serum osteocalcin and beta-crosslaps (markers of bone metabolism), seasonal variability of vitamin D, and bone mineral density were assessed and followed throughout the yearlong treatment regimen of infliximab in 50 consecutive paediatric patients with moderate to severe Crohn's disease.


RESULTS
Bone forming osteocalcin levels were significantly (p<0.001) increased during infliximab therapy. In contrast, no significant changes in beta-crosslaps and vitamin D levels were observed. Vitamin D levels were significantly different when the summer and winter periods were compared at week 0 (p=0.039); however, this difference was not detected after one year of infliximab therapy. Despite the beneficial clinical effect of infliximab, there was no significant change in bone mineral density Z-scores after one year of treatment.


CONCLUSION
Infliximab may beneficially affect bone homeostasis. Moreover, seasonal variability in vitamin D levels observed prior to initiation of infliximab treatment was diminished after one year of treatment.
['Szabó|Dolóresz|D|', 'Hosszú|Éva|É|', 'Arató|András|A|', 'Müller|Katalin Eszter|KE|', 'Béres|Nóra|N|', 'Lakatos|Péter László|PL|', 'Papp|Mária|M|', 'Dezsőfi|Antal|A|', 'Szabó|Attila J|AJ|', 'Szűcs|Dániel|D|', 'Veres|Gabor|G|']
D000293:Adolescent D015519:Bone Density D001842:Bone and Bones D002648:Child D003424:Crohn Disease D005260:Female D005765:Gastrointestinal Agents D006706:Homeostasis D006801:Humans D000069285:Infliximab D008297:Male D015675:Osteocalcin D011446:Prospective Studies D012621:Seasons D012720:Severity of Illness Index D014807:Vitamin D
Vitamin D Paediatric Crohn's disease Bone mineral density Infliximab Bone markers