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 high dose 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, . . .
Overview Gut and vitamin D contains 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
162 items in GUT category - see also Overview Gut and vitamin D,
- "Ulcerative Colitis" OR UC 839 items Jan 2020
- "celiac disease" OR CD 1830 items July 2019
- "inflammatory bowel disease" OR "inflammatory bowel symptom" 1630 items as of Jan 2020
- Crohn's 1230 items as of Feb 2019
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection . .
AIM: To study the association between vitamin D level and hospitalization rate in Crohn's disease (CD) patients.
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.
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
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