Vitamin C Deficiency and the Risk of Osteoporosis in Patients with an Inflammatory Bowel Disease

Nutrients. 2020 Jul 29;12(8):2263. doi: 10.3390/nu12082263.

Abstract

Recent research studies have shown that vitamin C (ascorbic acid) may affect bone mineral density and that a deficiency of ascorbic acid leads to the development of osteoporosis. Patients suffering from an inflammatory bowel disease are at a risk of low bone mineral density. It is vital to notice that patients with Crohn's disease and ulcerative colitis also are at risk of vitamin C deficiency which is due to factors such as reduced consumption of fresh vegetables and fruits, i.e., the main sources of ascorbic acid. Additionally, some patients follow diets which may provide an insufficient amount of vitamin C. Moreover, serum vitamin C level also is dependent on genetic factors, such as SLC23A1 and SLC23A2 genes, encoding sodium-dependent vitamin C transporters and GSTM1, GSTP1 and GSTT1 genes which encode glutathione S-transferases. Furthermore, ascorbic acid may modify the composition of gut microbiota which plays a role in the pathogenesis of an inflammatory bowel disease.

Keywords: diet; gastrointestinal microbiota; glutathione transferase; inflammatory bowel disease; osteoporosis; supplementation; vitamin C.

Publication types

  • Review

MeSH terms

  • Ascorbic Acid / blood*
  • Ascorbic Acid Deficiency / blood*
  • Ascorbic Acid Deficiency / etiology
  • Ascorbic Acid Deficiency / genetics
  • Bone Density
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / genetics
  • Crohn Disease / blood
  • Crohn Disease / complications
  • Crohn Disease / genetics
  • Diet / adverse effects
  • Female
  • Gastrointestinal Microbiome / physiology
  • Glutathione S-Transferase pi / blood
  • Glutathione Transferase / blood
  • Humans
  • Inflammatory Bowel Diseases / blood*
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / genetics
  • Male
  • Osteoporosis / etiology*
  • Osteoporosis / genetics
  • Risk Factors
  • Sodium-Coupled Vitamin C Transporters / blood

Substances

  • SLC23A1 protein, human
  • SLC23A2 protein, human
  • Sodium-Coupled Vitamin C Transporters
  • glutathione S-transferase T1
  • GSTP1 protein, human
  • Glutathione S-Transferase pi
  • Glutathione Transferase
  • glutathione S-transferase M1
  • Ascorbic Acid