Deficiency of vitamin D and its relation with clinical and laboratory activity of inflammatory bowel diseases (original) (raw)
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A Prospective Study of Vitamin D Status and Risk of Incident Crohn's Disease and Ulcerative Colitis
Gastroenterology, 2011
Background and aim of the work: There is increasing interest in the role of vitamin D in inflammatory bowel disease(IBD),outside of its traditional role in metabolic bone disease. Novel insights into additional roles for vitamin D are being established and these include anti-inflammatory and immune modulating effects. Therefore, this study was planned to assess the level of vitamin D variations among ulcerative colitis patients in Egypt. After departmental ethical committee approval and participants consent were obtained Twenty(20) patients with ulcerative colitis(UC) (group I), and Ten(10) apparently healthy persons (group II) as control group were enrolled in the study. Ulcerative colitis patients was diagnosed through, full history taking, clinical assessment, laboratory investigations, colonoscopic and histopathological studies. The control group was subjected to diagnostic modalities aspatients group apart from Colonoscopic and histopathological studies, and matched with patients group for age and sex. Group (1) ages ranged from 21-60 years, mean age was (36.95) 13 were females (65%) and 7 were males (35%). Group (11) ages ranged from 20-58 years, mean age was (37.60) 6 were females(60%) and 4 were males (40%). Results of this study revealed: The mean serum values of 25(OH) vitamin D in patients group(I) were lower in comparison to control group (II) (23.0±13.49 ng/dl and 36.2±5.9 ng/dl) respectively. This difference was statistically significant (P<0.007). Laboratory data of studied groups showed statistically significant difference between controls and patients group regarding HB, C-reactive protein, and serum calcium levels (P-value 0.000) respectively, as there were decreased level of HB and serum calcium in patients group compared to controls, however, increased CRP levels in patients group. White blood cells (WBCs) was higher in patients group compared to controls. In ulcerative colitis patients, there were inverse correlation between frequency of bloody stools/day and CRP with vitamin D levels which statistically significant (P= 0.003, 0.000) respectively. Serum calcium and vitamin D levels were in direct correlation and statistically significant (P=0.000). There were no correlation between age, WBCs, platelets, s. albumin, s. creatinine and INR with vitamin D levels. The patient group was classified into 3 subgroups: deficiency subgroup (9 patients) with main serum values of 25(OH) vitamin D (14.4±2.86 ng/ml), insufficiency subgroup (8 patients) (24.19±2.76 ng/ml) and sufficiency subgroup(3 patients) (33.67±3.06 ng/ml.). There was an evidence of exacerbation of activity of ulcerative colitis correlated to the degree of decreasing of vitamin D level. There were significant increase in frequency of bloody stool motions/day, ESR, and C-reactive protein (CRP), with the degree of decrease of vitamin D levels in patients subgroups. However, there were decrease of haemoglobin, serum phosphate & calcium with the degree of lowered vitamin D level in patients with ulcerative colitis. Conclusions: vitamin D [25(OH) D] deficiency is common in ulcerative colitis patients, the increased the degree of vitamin D deficiency, is associated with the increased the degree of activity of ulcerative colitis disease, which may support suggestion of vitamin D level is a potential contributing factor underlying the pathogenesis and disease activity of ulcerative colitis.
Revista Española de Enfermedades Digestivas
Introduction: there are few data on the prevalence of vitamin D deficiency in patients with inflammatory bowel disease (IBD) in Spain. A deficiency could be associated with a worse course of the disease. Aim: to determine the prevalence of 25-hydroxyvitamin D (25OHD) deficiency in a cohort of outpatients with IBD and assess its association with clinical and biological activity, quality of life and psychological symptoms. Methods: a cross-sectional, single-center observational study was performed. The study variables were obtained via clinical interviews, medical chart review and validated questionnaires (Hospital Anxiety and Depression Scale and Short Quality of Life in Inflammatory Bowel Disease Questionnaire). 25OHD was measured in the same laboratory by an electro-chemiluminescence immunoassay. Results: the study included 224 patients. The prevalence of vitamin D deficiency in Crohn's disease and ulcerative colitis was 33.3% and 20.3%, respectively. In Crohn's disease, vitamin D deficiency was associated with a higher clinical activity (p < 0.001) and a higher concentration of fecal calprotectin (p = 0.01). In ulcerative colitis, it was associated with clinical activity (p < 0.001), the use of steroids during the last six months (p = 0.001) and hospital admission during the previous year (p = 0.003). A subanalysis of 149 patients failed to detect an association between vitamin D and quality of life or the scores of the Hospital Anxiety and Depression Scale. Conclusions: vitamin D deficiency is common in patients with inflammatory bowel disease. An association was found between vitamin D concentration and clinical activity indexes, as well as fecal calprotectin levels in Crohn's disease.
Acta Clinica Croatica
-Inflammatory bowel disease (IBD) patients with vitamin D deficiency show an increased risk of hospital admission, surgery, and loss of response to biologic therapy while high vitamin D levels are identified as a protective factor. Our goal was to investigate the prevalence of untreated and undertreated vitamin D deficiency and factors associated with vitamin D deficiency. In this cross-sectional study, we measured serum vitamin D in a random sample of Caucasian IBD patients. Vitamin D deficiency was defined as <50 nmol/L and insufficiency as 50-75 nmol/L. Supplementation was defined as taking 800-2000 IU vitamin D daily. Untreated patients were defined as not taking supplementation and undertreated group as receiving supplementation but showing vitamin D deficiency or insufficiency despite treatment. Our study included 185 IBD patients, i.e. 126 (68.1%) with Crohn's disease (CD) and 59 (31.9%) with ulcerative colitis (UC). Overall, 108 (58.4%) patients had vitamin D deficiency and 60 (32.4%) patients vitamin D insufficiency. There were 16 (14.8%) and 11 (18.3%) treated patients in vitamin D deficiency and vitamin D insufficiency group, respectively. The rate of untreated patients was 81.7% (n=49) in vitamin D deficiency group and 85.2% (n=92) in vitamin D insufficiency group. Tumor necrosis factor alpha inhibitors were associated with higher serum vitamin D levels in CD and UC, and ileal involvement, ileal and ileocolonic resection with lower levels. In conclusion, not only is vitamin D deficiency common in IBD patients but the proportion of untreated and undertreated patients is considerably high. We suggest regular monitoring of vitamin D levels in IBD patients regardless of receiving vitamin D supplementation therapy.
World Journal of Gastroenterology, 2017
AIM To identify the predictors of vitamin D deficiency in patients with and without inflammatory bowel disease (IBD). METHODS Patients with ulcerative colitis (UC) or Crohn's disease (CD) related diagnostic codes who received medical care at University of Mississippi Medical Center between July 2012 and 2015 were identified. After thorough chart review, we identified patients with biopsy proven IBD who had also been tested for serum 25-hydroxyvitamin D [25(OH)D] concentration. We compared these patients to a previously studied cohort of healthy controls who also had vitamin D concentration checked. Logistic regression analysis was performed to determine the association between vitamin d deficiency and UC, CD, race, age, gender and body mass index (BMI). RESULTS We identified 237 patients with confirmed IBD. Of these, only 211 had a serum 25(OH)D concentrations available in the medical record. The group of healthy controls consisted of 98 individuals with available serum 25(OH)D concentration. 43% of IBD patients were African American (AA). Patients with CD were more likely to have vitamin D concentration checked. Bivariate analysis showed that AA (51% vs 21%, P
Vitamin D Deficiency in Patients With Inflammatory Bowel Disease
Journal of Parenteral …, 2011
The findings of significant prevalence of severe vitamin D deficiency in Irritable Bowel Disease (IBD), as well as independent association between low vitamin D levels and increased disease activity and lower health-related quality of life in IBD patients, particularly those with Crohn's
Middle East journal of digestive diseases, 2018
BACKGROUND Inflammatory bowel disease (IBD), Crohn's disease (CD), and Ulcerative colitis (UC) are autoimmune inflammatory diseases of the alimentary tract, which seems to be caused by the interaction of environmental and genetic factors as well as diet and nutritional factors such as vitamin D. The aim of this study was to assess the vitamin D status and its associations with erythrocyte sedimentation rate (ESR), and high-sensitivity C-reactive protein (hs-CRP) as inflammatory markers in patients with UC. METHODS In this analytical cross-sectional study 90 patients with mild to moderate UC who were resident of Tehran were assessed. 25(OH)D, parathyroid hormone (PTH), ESR and hs-CRP were measured. Dietary intake was assessed by 3-day 24h diet recall. Statistical analyses were performed using STATA (Version 12). RESULTS The average serum 25-OH-vitamin D3 was 33.1 ± 8.3 ng/mL and 38.9% of the patients were vitamin D deficient or insufficient (37.3% of men and 41% of women). No sig...
Ain Shams Medical Journal, 2021
Background: Vitamin D is a steroid hormone that is produced as a result of skin exposure to the sunlight. Vitamin D is essential to different organs and systems in the body as the bones, intestines, immune system, pancreas, brain, and control of cell cycle. Aim of the work: to assess the clinical relevance of vitamin D in colonic diseases (IBS and IBD) to know if there is a prevalence of vitamin D deficiency in these colonic diseases. Patients and Methods: This study was performed on 90 Egyptian patients who were classified into 3 groups; where Group 1 included 30 patients who have irritable bowel syndrome (IBS), Group 2 30 patients who have inflammatory bowel disease (IBD) whether Ulcerative Colitis (UC) or Crohn's Disease (CD) and Group 3 30 healthy personnel taken as Control group. Results: Regarding different vitamin D levels in the studied groups. In the control group, (20%) had deficient vitamin D level (< 20 ng/ml), (30%) had insufficient vitamin D level (20-30 ng/ml), (50%) had optimal vitamin D level (>30 ng/ml). In IBS group, (60%) had deficient vitamin D level, (26.7%) had insufficient vitamin D level, (13.3%) had optimal vitamin D level. In the UC group, (66.7%) had deficient vitamin D level, (16.7%) had insufficient vitamin D level, (16.7%) had optimal vitamin D level. In CD group, (50%) had deficient vitamin D level, (33.3%) had insufficient vitamin D level, (16.7%) had optimal vitamin D level. Conclusion: The role of vitamin D deficiency in the pathogenesis of many chronic illnesses has raised the attention recently. Our study revealed that 25-OH-D3 deficiency is found more frequently among UC, CD and IBS patients than normal healthy controls. Thus, vitamin D prescription in these patients may help in improving these colonic diseases.
Vitamin D deficiency in a European inflammatory bowel disease inception cohort: an Epi-IBD study
European journal of gastroenterology & hepatology, 2018
Serum vitamin D level is commonly low in patients with inflammatory bowel disease (IBD). Although there is a growing body of evidence that links low vitamin D level to certain aspects of IBD such as disease activity and quality of life, data on its prevalence and how it varies across disease phenotype, smoking status and treatment groups are still missing. Patients diagnosed with IBD between 2010 and 2011 were recruited. Demographic data and serum vitamin D levels were collected. Variance of vitamin D level was then assessed across different treatment groups, disease phenotype, disease activity and quality of life scores. A total of 238 (55.9% male) patients were included. Overall, 79% of the patients had either insufficient or deficient levels of vitamin D at diagnosis. Patients needing corticosteroid treatment at 1 year had significantly lower vitamin D levels at diagnosis (median 36.0 nmol/l) (P=0.035). Harvey-Bradshaw Index (P=0.0001) and Simple Clinical Colitis Activity Index s...
Vitamin D Therapy in Inflammatory Bowel Diseases: Who, in What Form, and How Much?
Journal of Crohn's and Colitis, 2014
The north-south geographical gradient of inflammatory bowel disease (IBD) prevalence, its epidemiology, the genetic association of vitamin D receptor polymorphisms, and results in animal models suggest that vitamin D plays an important role in the pathogenesis of IBD. Aims: The purpose of this review was to critically appraise the effectiveness and safety of vitamin D therapy in patients with IBD. Methods: MEDLINE, Scopus and Google Scholar were searched from inception to May 20, 2014 using the terms 'Crohn's disease', 'ulcerative colitis' and 'vitamin D'. Results: Vitamin D deficiency is common in patients with IBD. Limited clinical data suggest an association between low vitamin D concentration and increased disease activity in both ulcerative colitis (UC) and Crohn's disease (CD). To date, only two small open label trials and one randomized controlled trial have shown a positive effect of vitamin D supplementation on disease activity in patients with CD; no effect has been shown for UC. An optimal vitamin D supplementation protocol for patients with IBD remains undetermined, but targeting serum 25-hydroxy vitamin D [25(OH)D] levels between 30 and 50 ng/mL appears safe and may have benefits for IBD disease activity. Depending on baseline vitamin D serum concentration, ileal involvement in CD, body mass index, and perhaps smoking status, daily vitamin D doses between 1 800-10 000 international units/day are probably necessary. Conclusion: Increasing preclinical and clinical evidence suggests a role for vitamin D deficiency in the development and severity of IBD. The possible therapeutic role of vitamin D in patients with IBD merits continued investigation.