Crohn's patients with Vitamin D less than 30 ng were 1.8 X more likely to be readmitted within 1 year

Created March 2018

Impact of vitamin D on the hospitalization rate of Crohn's disease patients seen at a tertiary care center.

World J Gastroenterol. 2017 Apr 14;23(14):2539-2544. doi: 10.3748/wjg.v23.i14.2539.

Venkata KVR, Arora SS, Xie FL1, Malik TA

Krishna VR Venkata, Sumant S Arora, Department of Internal Medicine, University of Alabama at Birmingham Montgomery Health Center, Montgomery, AL 36116, United States.

* Note: Only 1/4 of the Crohn’s patients had a vitamin D test. * Perhaps the 3/4 which did not have a test were more likely to have higher levels of vitamin D * If so, the 1.8 X reduced re-hospitalization rate might be 4X --- Yes, Vitamin D both prevents and treats many gut problems * Gut microbiome massively changed by weekly vitamin D – July 2015 * Crohn’s disease associated with vitamin D and latitude – meta-analysis Dec 2015 * 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 * Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015 Vitamin D Receptor limits the amount of vitamin D actually getting to Crohn's cells * Crohn's disease associated with 7.6X deactivation of Vitamin D receptor – July 2015 * Thus little vitamin D gets to cells in people with Crohn's disease unless * take more (or better form of) vitamin D, Omega-3, Resveratrol, Magnesium, . . . 1. Overview Gut and vitamin D contains the following summary {include} 1. Gut category listing contains the following {include}

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AIM: To study the association between vitamin D level and hospitalization rate in Crohn's disease (CD) patients.

METHODS:

We designed a retrospective cohort study using adult patients (> 19 years) with CD followed for at least one year at our inflammatory bowel disease center. Vitamin D levels were divided into: low mean vitamin D level (< 30 ng/mL) vs appropriate mean vitamin D level (30-100 ng/mL). Generalized Poisson Regression Models (GPR) for Rate Data were used to estimate partially adjusted and fully adjusted incidence rate ratios (IRR) of hospitalization among CD patients. We also examined IRRs for vitamin D level as a continuous variable.

RESULTS:

Of the 880 CD patients, 196 patients with vitamin D level during the observation period were included. Partially adjusted model demonstrated that CD patients with a low mean vitamin D level were almost twice more likely to be admitted (IRR = 1.76, 95%CI: 1.38-2.24) compared to those with an appropriate vitamin D level. The fully adjusted model confirmed this association (IRR = 1.44, 95%CI: 1.11-1.87). Partially adjusted model with vitamin D level as a continuous variable demonstrated, higher mean vitamin D level was associated with a 3% lower likelihood of admission with every unit (ng/mL) rise in mean vitamin D level (IRR = 0.97, 95%CI: 0.96-0.98). The fully adjusted model confirmed this association (IRR = 0.98, 95%CI: 0.97-0.99).

CONCLUSION: Normal or adequate vitamin D stores may be protective in the clinical course of CD. However, this role needs to be further characterized and understood.

PMID: 28465638 PMCID: PMC5394517 DOI: 10.3748/wjg.v23.i14.2539

Crohn's Disease graphic from the web

Tags: Gut