Inflammatory Bowel Disease associated with many more problems if low vitamin D

Created June 2017

Association of Vitamin D Level With Clinical Status in Inflammatory Bowel Disease: A 5-Year Longitudinal Study.

Am J Gastroenterol. 2016 May;111(5):712-9. doi: 10.1038/ajg.2016.53. Epub 2016 Mar 8.

Kabbani TA1, Koutroubakis IE1, Schoen RE1, Ramos-Rivers C1, Shah N1, Swoger J1, Regueiro M1, Barrie A1, Schwartz M1, Hashash JG1, Baidoo L1, Dunn MA1, Binion DG1.

Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

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OBJECTIVES:

Emerging data suggest that vitamin D has a significant role in inflammatory bowel disease (IBD). Prospective data evaluating the association of vitamin D serum status and disease course are lacking. We sought to determine the relationship between vitamin D status and clinical course of IBD over a multiyear time period.

METHODS:

IBD patients with up to 5-year follow-up from a longitudinal IBD natural history registry were included. Patients were categorized according to their mean serum 25-OH vitamin D level. IBD clinical status was approximated with patterns of medication use, health-care utilization, biochemical markers of inflammation (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)), pain and clinical disease activity scores, and health-related quality of life.

RESULTS:

A total of 965 IBD patients (61.9% Crohn's disease, 38.1% ulcerative colitis) formed the study population (mean age 44 years, 52.3% female).

Among them, 29.9% had low mean vitamin D levels.

Over the 5-year study period, subjects with low mean vitamin D required significantly more

  • steroids,

  • biologics,

  • narcotics,

  • computed tomography scans,

  • emergency department visits,

  • hospital admissions, and

  • surgery

compared with subjects with normal mean vitamin D levels (P<0.05).

Moreover, subjects with low vitamin D levels had worse

  • pain,

  • disease activity scores, and

  • quality of life (P<0.05).

Finally, subjects who received vitamin D supplements had a significant reduction in their health-care utilization.

CONCLUSIONS:

Low vitamin D levels are common in IBD patients and are associated with higher morbidity and disease severity, signifying the potential importance of vitamin D monitoring and treatment.

PMID: 26952579 DOI: 10.1038/ajg.2016.53 Behind publisher paywall

Tags: Gut