Clinical Gastroenterology and Hepatology; V 11, Issue 12 , Pages 1631-1635, Dec 2013
Lillias H. Maguire, Mingyang Song , Lisa E. Strate , Edward L. Giovannucci , Andrew T. Chan
Background & Aims: Recent studies have shown geographic and seasonal variations in hospital admissions for diverticulitis. Because this variation parallels differences in ultraviolet light exposure, the most important contributor to vitamin D status, we examined the association of prediagnostic serum levels of vitamin D with diverticulitis.
Methods: Among patients within the Partners Healthcare System who had blood drawn and serum levels of 25-hydroxyvitamin D (25-[OH]D) measured, from 1993 through 2012, we identified
- 9116 patients with uncomplicated diverticulosis and
- 922 patients who developed diverticulitis that required hospitalization.
We used multivariate logistic regression to estimate relative risks and 95% confidence intervals to compare serum 25(OH)D levels between these groups.
Results: Patients with uncomplicated diverticulosis had significantly higher mean prediagnostic serum levels of 25(OH)D (29.1 ng/mL) than patients with diverticulitis who required hospitalization (25.3 ng/mL; P < .0001).
Compared with patients in the lowest quintile of 25(OH)D, the multivariate-adjusted relative risk for diverticulitis hospitalization was 0.49 (95% confidence interval, 0.38–0.62; P for trend < .0001) among patients in the highest quintile of 25(OH)D level.
Compared with patients with uncomplicated diverticulosis, the mean level of 25(OH)D was significantly lower for patients with
- acute diverticulitis without other sequelae (25.9 ng/mL; P < .0001; n = 594), for patients with diverticulitis with
- abscess (25.8 ng/mL; P = .0095; n = 124), for patients with
- diverticulitis requiring emergent laparotomy (22.7 ng/mL; P = .002; n = 65), and for patients with
- recurrent diverticulitis (23.5 ng/mL; P < .0001; n = 139).
Conclusions: Among patients with diverticulosis, higher prediagnostic levels of 25(OH)D are associated significantly with a lower risk of diverticulitis. These data indicate that vitamin D deficiency could be involved in the pathogenesis of diverticulitis.
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Note: this study identifies an association. It could easily be that the pathway is diverticulitis ==> Inflammation ==> consumes vitamin D ==> lowers the levels
- Search VitaminDWiki for diverticulitis 10 items as of Jan 2019
- Muscle inflammation 17X more probable if vitamin D deficient – Feb 2013
- Vitamin D decrease during inflammation is probably due to interferons - Oct 2012
- Hypothesis – vitamin D will decrease chronic inflammation and fatigue – Oct 2010
- Inflammatory bowel diseases are helped by vitamin D – commissioned review Nov 2013
- Gut doctors becoming aware of importance of vitamin D – May 2012
- People with gut problems are low on vitamin D
- Overview Gut and vitamin D - has a section on gui-friendly forms Vitamin D
- Bio-emulsified drops doubled vitamin D levels – Dec 2010 designed for people with poorly functioning guts
Other possibilities, which apparently do not need the gut, include vitamin D spray and sublingual vitamin D miro-tabs
- Piglets helped a lot with 40,000 IU on day 1, provided they did not have diarrhea – Aug 2013 piglets with poor guts make poor use of vitamin D, just like humans
Association of geographic and seasonal variation with diverticulitis admissions Jan 2015
JAMA Surg. 2015 Jan;150(1):74-7. doi: 10.1001/jamasurg.2014.2049.
Maguire LH1, Song M2, Strate LL3, Giovannucci EL4, Chan AT5.
The incidence of diverticulitis has been associated with geographic and seasonal variation. Low levels of circulating vitamin D are associated with diverticulitis. We investigated the association between UV light and diverticulitis.
We identified nonelective diverticulitis admissions in the Nationwide Inpatient Sample and linked hospital locations to UV data. We examined UV exposure in relation to risk of admission for diverticulitis. We identified geographic and seasonal trends among 226 522 nonelective admissions for diverticulitis.
Compared with high-UV areas, low-UV areas had a higher rate of diverticulitis (751.8 vs 668.1 per 100 000 admissions; P < .001), diverticular abscess (12.0% vs 9.7%; P < .001), and colectomy (13.5% vs 11.5%; P < .001).
We also observed significant seasonal variation, with a lower rate of diverticulitis in the winter (645 per 100 000) compared with the summer (748 per 100 000) (P < .001). The summer increase was more evident in areas with the greatest UV fluctuation vs areas with the least UV fluctuation (120 vs 70 per 100 000; P = .01).
CONCLUSIONS AND RELEVANCE:
Low UV light exposure is associated with an increased rate of diverticulitis admissions and greater seasonal variation. Because UV exposure largely determines vitamin D status, these findings support a role for vitamin D in the pathogenesis of diverticulitis.
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