Crohn’s disease associated with low vitamin D, unless in remission (22 vs 28ng)– Dec 2015

LOWER LEVELS OF VITAMIN D CORRELATE WITH CLINICAL DISEASE ACTIVITY AND QUALITY OF LIFE IN INFLAMMATORY BOWEL DISEASE.

Arq Gastroenterol. 2015 Dec;52(4):260-5. doi: 10.1590/S0004-28032015000400003.
Castro FD1, Magalhães J1, Carvalho PB1, Moreira MJ1, Mota P2, Cotter J1.
1Departamento de Gastroenterologia, Centro Hospitalar do Alto Ave, Guimarães, Portugal.
2Departamento de Patologia Clínica, Centro Hospitalar do Alto Ave, Guimarães, Portugal.

BACKGROUND:
Inflammatory bowel disease, comprising Crohn's disease and ulcerative colitis, is a group of debilitating conditions associated with deregulated mucosal immune response. Vitamin D has been implicated in immune response and gastrointestinal function.

OBJECTIVES:
To investigate the correlation between serum vitamin D levels and disease activity and quality of life in patients with inflammatory bowel disease.

METHODS:
This cross-sectional study enrolled ambulatory patients with inflammatory bowel disease and assessed clinical disease activity and quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ]). Vitamin D levels were determined via serum 25-hydroxyvitamin D measurement; deficiency was defined as values <20 ng/mL. Statistical analysis was performed with SPSS vs 20.0.

RESULTS:
A total of 76 patients were enrolled, 19 with ulcerative colitis (25%) and 57 with Crohn's disease (75%). Overall, mean serum 25-hydroxyvitamin D levels were low (26.0±10.0 ng/mL), while those in patients with Crohn's disease were significantly lower than ulcerative colitis (24.6±8.0 vs 30.0±12.5 ng/mL; P=0.032). Vitamin D deficiency was found in 30% of patients. Patients who were in clinical remission were found to have higher levels of vitamin D than those who were not in remission (28.0±10.3 vs 21.6±6.0 ng/mL, P=0.001). Inflammatory bowel disease patients with SIBDQ scores <50 were found to have significantly lower mean vitamin D levels compared with patients who had SIBDQ scores =50 (23.4±6.9 vs 27.9±10.8 ng/mL, P=0.041).

CONCLUSIONS:
A high proportion of patients with inflammatory bowel disease were vitamin D deficient, particularly patients with Crohn's disease. Both clinical disease activity and quality of life correlated significantly with lower levels of vitamin D, illustrating a clear need for supplementation in patients with inflammatory bowel disease.

PMID: 26840465

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