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Crohn’s Disease Activity predicted by vitamin D plus 2 additional blood tests – Dec 2018

A New Model Based on 25-Hydroxyvitamin D3 for Predicting Active Crohn's Disease in Chinese Patients.

Mediators Inflamm. 2018 Dec 16;2018:3275025. doi: 10.1155/2018/3275025. eCollection 2018.
Lin S1, Wang Y1, Li L1, Chen P1, Mao R1, Feng R1, Qiu Y1, He Y1, Chen B1, Zeng Z1, Chen M1, Zhang S1.

VitaminDWiki

Overview Gut and vitamin D has the following summary

  • Gut problems result in reduced absorption of Vitamin D, Magnesium, etc.
  • Celiac disease has a strong genetic component.
    • Most, but not all, people with celiac disease have a gene variant.
    • An adequate level vitamin D seems to decrease the probability of getting celiac disease.
    • Celiac disease causes poor absorption of nutrients such as vitamin D.
    • Bringing the blood level of vitamin D back to normal in patients with celiac disease decreases symptoms.
    • The prevalence of celiac disease, not just its diagnosis, has increased 4X in the past 30 years, similar to the increase in Vitamin D deficiency.
  • Review in Nov 2013 found that Vitamin D helped
    Many intervention clinical trials with vitamin D for Gut problems (101 trials listed as of Sept 2019)
  • All items in category gut and vitamin D 169 items


Overview Gut and vitamin D contains gut-friendly information

Gut-friendly, Sublingual, injection, topical, UV, sunshine

Getting Vitamin D into your body has the following chart
Image

Getting Vitamin D into your body also has the following

If poorly functioning gut

Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into bloodstream
   you can make your own sublinqual by dissovling Vitamin D in water or using nanoemulsion form
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into bloodstream. Prescription only?
Bio-Tech might be usefulit is also water soluble
Vitamin D sprayed inside cheeks 2X more response (poor gut) – RCT Oct 2015
    and, those people with malabsorption problems had a larger response to spray
Inject Vitamin D quarterly into muscle, into vein, or perhaps into body cavity if quickly needed
Nanoparticles could be used to increase vitamin D getting to the gut – Oct 2015
Poor guts need different forms of vitamin D has the following
Guesses of Vitamin D response if poor gut

Bio FormSpeedDuration
10Injection ($$$)
or Calcidiol or Calcitriol
D - Slow
C -Fast
Long
10 Sun/UVBSlowLong
10Topical
(skin patch/cream, vagina)
Slow
Fast nano
Normal
9Nanoemulsion -mucosal
perhaps activates VDR
FastNormal
9?Inhaled (future)FastNormal
8Bio-D-Mulsion ForteNormalNormal
6Water soluble (Bio-Tech)NormalNormal
4Sublingual/spray
(some goes into gut)
FastNormal
3Coconut oil basedSlowNormal
2Food (salmon etc.)SlowNormal
2Olive oil based (majority)SlowNormal

10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months


Gut category listing contains the following

169 items in GUT category - see also Overview Gut and vitamin D,

 Download the PDF from VitaminDWiki
Addition of 2 other variables increases accuracy of activity prediction
Image

Resulting nomogram
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BACKGROUND:
The association between vitamin D3 and activity of Crohn's disease (CD) is unclear in Chinese patients. In this study, we aimed to evaluate the correlations between serum levels of 25-hydroxyvitamin D3 (25(OH)D3) and disease activity and predict active disease based on vitamin D status.

METHODS:
Between January 2014 and December 2017, 346 CD patients from the First Affiliated Hospital of Sun Yat-sen University were recruited and categorized into a group with 25(OH)D3 ≤ 20 ng/ml and a group with 25(OH)D3 > 20 ng/ml. The clinical characteristics, medication, and health-care needs were compared between the groups. The correlations among 25(OH)D3 and routine serum biomarkers and disease activity were examined. The predictive efficiency of 25(OH)D3 and other biomarkers for active diseases was also explored using receiver-operating characteristic (ROC) curve analysis. A new predictive model, -(5∗25(OH)D3 + 2∗Hb) + ESR, and a nomogram were established using Logistic Regression.

RESULTS:
Patients with 25(OH)D3 ≤ 20 ng/ml had higher serum levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and platelets (PLT) and lower levels of hemoglobin (Hb) and albumin (ALB). Serum levels of 25(OH)D3 were inversely correlated with the score of Crohn's Disease Activity Index (CDAI) (r s = -0.608). ROC analysis showed a better predictive value of -25(OH)D3 and the new model with areas under curve (AUC) of 0.804 and 0.879, respectively, than those of CRP (0.693) and ESR (0.713) in disease activity. A nomogram for prediction was established with a c-index of 0.882.

CONCLUSIONS:
Serum levels of 25(OH)D3 negatively correlated with CD activity in Chinese patients. The new model and a nomogram based on 25(OH)D3 showed a better efficiency in predicting disease activity in CD patients but warrants further study.


Created by admin. Last Modification: Tuesday May 7, 2019 18:30:40 GMT-0000 by admin. (Version 4)

Attached files

ID Name Comment Uploaded Size Downloads
11913 Nomogram.jpg admin 07 May, 2019 18:26 46.08 Kb 189
11912 ROC.jpg admin 07 May, 2019 18:25 32.28 Kb 206
11911 MI2018-3275025.pdf PDF 2018 admin 07 May, 2019 18:25 789.84 Kb 219
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