Systematic review with meta-analysis: association of vitamin D status with clinical outcomes in adult patients with inflammatory bowel disease.
Aliment Pharmacol Ther. 2019 Dec;50(11-12):1146-1158. doi: 10.1111/apt.15506. Epub 2019 Oct 24.
Gubatan J1,2, Chou ND1, Nielsen OH3, Moss AC1.
The Meta-analysis of Gut and Vitamin D
- Inflammatory Bowel Disease 1.5 X more likely if low vitamin D – meta-analysis Dec 2019
- Crohn’s Disease associated with lower Vitamin D - meta-analysis Sept 2019
- Inflammatory bowel diseases are associated with Vitamin D etc. – meta-meta-analysis - April 2019
- IBD relapse rate reduced by low Vitamin D - meta-analysis Nov 2018
- Crohn’s disease associated with vitamin D and latitude – meta-analysis Dec 2015
- Gut problems more likely if low vitamin D (IBD: 1.6, UC: 2.3) – meta-analysis Aug 2015
All items in categories Intervention AND Gut
- Ulcerative Colitis significantly reduced by 480,000 IU loading dose of nano Vitamin D – RCT July 2019
- Irritable Bowel Syndrome treated by weekly 50,000 IU Vitamin D – RCT 2019
- Ulcerative Colitis inflammation treated by weekly vitamin D (40,000 IU) – July 2018
- Gut bacteria of Crohn's disease patients improved by Vitamin D – March 2018
- Vitamin D changed microbiota in gut and airway, might reduce cystic fibrosis – RCT Nov 2017
- Crohn's Disease relapse rate of 3 in 8 with 1,000 IU vs 0 in 12 with 10,000 IU of Vitamin D – RCT Feb 2017
- Ulcerative colitis treated by injection of 300,000 IU of vitamin D – RCT July 2016
- IBS quality of life improved by vitamin D (50,000 IU every two weeks) – RCT May 2016
- IBS – 82 percent had low vitamin D, 3,000 IU spray helped a lot – RCT Dec 2015
- Crohn's disease treated by 2000 IU Vitamin D - RCT June 2015
- Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015
- Irritable Bowel Syndrome - can it be treated by 3000 IU of vitamin D - RCT Feb 2014
- Crohn's Disease patients normalizing their Vitamin D levels decreased risk of surgery by 44 percent – Aug 2013
- Crohn’s helped by 5000 IU vitamin D – April 2013
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
Gut category listing contains the following
153 items in GUT category - see also Overview Gut and vitamin D,
- "Ulcerative Colitis" OR UC 689 items March 2019
- "celiac disease" OR CD 1830 items July 2019
- "inflammatory bowel disease" OR "inflammatory bowel symptom" 1010 items as of March 2019
- Crohn's 1230 items as of Feb 2019
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .
Vitamin D deficiency is highly prevalent among patients with IBD, however, data on its association with clinical outcomes are conflicting.
To perform a systematic review and meta-analysis to explore the association of low vitamin D status with clinical outcomes in patients with IBD.
We searched PubMed, Embase, Scopus and Web of Science from inception to February 2018 for observational studies evaluating the association of low 25(OH)D status on IBD disease activity, mucosal inflammation, clinical relapse and quality of life. Odds ratios (ORs) were pooled and analysed using a random effects model.
Twenty-seven studies were eligible for inclusion comprising 8316 IBD patients (3115 ulcerative colitis, 5201 Crohn's disease). Among IBD patients, low 25(OH)D status was associated with increased odds of
- disease activity (OR 1.53, 95% CI 1.32-1.77, I2 = 0%),
- mucosal inflammation (OR 1.25, 95% CI 1.06-1.47, I2 = 0%),
- low quality of life (QOL) scores (OR 1.30, 95% CI 1.06-1.60, I2 = 0%) and
- future clinical relapse (OR 1.23, 95% CI 1.03-1.47, I2 = 0%).
In subgroup analysis, low vitamin D status was associated with
- Crohn's disease activity (OR 1.66, 95% CI 1.36-2.03, I2 = 0%),
- mucosal inflammation (OR 1.39, 95% CI 1.03-1.85, I2 = 0%),
- clinical relapse (OR 1.35, 95% CI 1.14-1.59, I2 = 0%), and
- low QOL scores (OR 1.25, 95% CI 1.04-1.50, I2 = 0%) and
- ulcerative colitis disease activity (OR 1.47, 95% CI 1.03-2.09, I2 = 0%) and
- clinical relapse (OR 1.20, 95% 1.01-1.43, I2 = 0%).
CONCLUSIONS: Low 25(OH)D status is a biomarker for disease activity and predictor of poor clinical outcomes in IBD patients.