{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:51:37Z","timestamp":1787827897121,"version":"build-2784847793"},"reference-count":24,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2017,5,10]],"date-time":"2017-05-10T00:00:00Z","timestamp":1494374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>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 &gt;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\u201379) years and 23 (37%) were male. The mean HPN duration was 56 (6\u2013323) 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 \u00b1 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.<\/jats:p>","DOI":"10.3390\/nu9050481","type":"journal-article","created":{"date-parts":[[2017,5,10]],"date-time":"2017-05-10T12:04:20Z","timestamp":1494417860000},"page":"481","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["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"],"prefix":"10.3390","volume":"9","author":[{"given":"Navaporn","family":"Napartivaumnuay","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Gramlich","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada"},{"name":"Nutrition Services, Alberta Health Services, Edmonton, AB T5J 3E4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,5,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Christodoulou, S., Goula, T., Ververidis, A., and Drosos, G. (2013). Vitamin D and Bone Disease. BioMed Res. Int.","DOI":"10.1155\/2013\/396541"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Bikle, D. (2007). Vitamin D insfficiency\/deficiency in gastrointestinal disorders. J. Bone Miner Res.","DOI":"10.1359\/jbmr.07s208"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/0148607109349061","article-title":"The Role of Vitamin D in Adults Requiring Nutrition Therapy","volume":"34","author":"Pittas","year":"2010","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, treatment, and prevention of vitamin D deficieny: An endocrine society clinical practice guideline","volume":"96","author":"Holick","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1056\/NEJMra070553","article-title":"Vitamin D deficiency","volume":"357","author":"Holick","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1093\/ajcn\/38.2.264","article-title":"Amino acid-induced hypercalciuria in patients on total parenteral nutrition","volume":"38","author":"Bengoa","year":"1983","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1989","DOI":"10.1359\/jbmr.2003.18.11.1989","article-title":"Ostoporosis in patients on long-term parenteral nutrition: A longitudinal study","volume":"18","author":"Baudoin","year":"2003","journal-title":"J. Bone Miner Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1136\/bmj.312.7041.1254","article-title":"Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures","volume":"312","author":"Marshall","year":"1996","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.1359\/jbmr.2002.17.12.2222","article-title":"Prediction of fracture risk in postmenopausal white women with peripheral bone densitometry: Evidence from the National Osteoporosis Risk Assessment","volume":"17","author":"Miller","year":"2002","journal-title":"J. Bone Miner Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/BF02509538","article-title":"Assessement of vitamin D nutritional and hormonal status: What to measure and how to do it","volume":"58","author":"Hollis","year":"1996","journal-title":"Calcif. Tissue Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1087S","DOI":"10.1093\/ajcn\/87.4.1087S","article-title":"Blood biomarkers of vitamin D status","volume":"87","author":"Zerwekh","year":"2008","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s001980070064","article-title":"Long-term risk of osteoporotic fracture in Malmo","volume":"11","author":"Kanis","year":"2000","journal-title":"Osteoporos. Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.clnu.2013.02.005","article-title":"High prevalence of vitamin D deficiency and osteoporosis in out-patients with intestinal failure","volume":"32","author":"Kurlberg","year":"2013","journal-title":"Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1177\/0148607110381269","article-title":"Vitamin D deficiency in patients receiving home parenteral nutrition","volume":"35","author":"Thomson","year":"2011","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1177\/0148607111416483","article-title":"Prevalence of vitamin D deficiency and response to oral vitamin D supplementation in patients receiving home parenteral nutrition","volume":"36","author":"Kumar","year":"2012","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1177\/0884533614539178","article-title":"Prevalence and predictors of vitamin D deficiency and response to oral supplementation inpatients receiving long-term home parenteral nutrition","volume":"29","author":"Bharadwaj","year":"2014","journal-title":"Nutr. Clin. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1016\/j.clnu.2016.01.020","article-title":"ESPEN Guidelines on chronic intestinal failure in adult","volume":"35","author":"Pironi","year":"2016","journal-title":"Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"492","DOI":"10.1177\/0148607106030006492","article-title":"Metabolic bone disease in patients receiving home parenteral nutrition: A Canadian study and review","volume":"30","author":"Raman","year":"2006","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1177\/0148607193017003214","article-title":"Metabolic bone disease in adults receiving long-term parenteral nutrition: Longitudinal study with regional densitometry and bone biopsy","volume":"17","author":"Saitta","year":"1993","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1177\/0148607195019006431","article-title":"Increase in lumbar spine bone mineral content in patients on long-term parenteral nutrition without vitamin D supplementation","volume":"19","author":"Verhage","year":"1995","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_21","unstructured":"Kanis, J.A. (2007). WHO Technical Report, University of Sheffield."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1210\/jc.2011-3045","article-title":"Osteoporosis in Men: An Endocrine Society Clinical Practice Guideline","volume":"97","author":"Watts","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1210\/er.2004-0006","article-title":"Parathyroid hormone and teriparatide for the treatment of osteoporosis: A review of the evidence and suggested guideline for its use","volume":"26","author":"Hodsman","year":"2005","journal-title":"Endocr. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1177\/0148607111431983","article-title":"The Canadian Home Total Parenteral Nutrition (HTPN) Registry: Vitamin K supplementation and bone mineral density","volume":"36","author":"Aljarallah","year":"2012","journal-title":"J. Parenter. Enter. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/5\/481\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:35:18Z","timestamp":1760207718000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/5\/481"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,10]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2017,5]]}},"alternative-id":["nu9050481"],"URL":"https:\/\/doi.org\/10.3390\/nu9050481","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,10]]}}}