Active Crohn's disease is associated with low vitamin D levels

Abstract

Background and aims: Crohn's disease prevalence increases with increasing latitude. Because most vitamin D comes from sunlight exposure and murine models of intestinal inflammation have demonstrated beneficial effects of 1,25-(OH) 2 vitamin D treatment, we hypothesised that Crohn's disease activity is associated with low vitamin D levels. Methods: In a cross-sectional study of 182 CD patients and 62 healthy controls, we measured serum 25-OH vitamin D. Stratified analysis was used to compare 25-OH vitamin D levels with Crohn's disease activity index, C-reactive protein, smoking status, intake of oral vitamin D supplements and seasonal variation in CD patients and healthy controls.

Vitamin D Therapy in Inflammatory Bowel Diseases: Who, in What Form, and How Much?

“…For example, 25(OH)D concentrations were significantly higher in CD patients who took 400-800 IU/day vitamin D than in those who did not (31 versus 22 ng/mL, respectively, p < 0.01). 52 In addition, a recent study of 83 pediatric CD patients found that supplementation with 400 IU and 2 000 IU vitamin D daily for 3 months increased mean serum 25(OH)D concentrations by 2.8 ng/mL and 16 ng/mL, respectively, over baseline. 124 In an Irish study, a supplement containing 200-400 IU/day vitamin D was insufficient in preventing vitamin D deficiency in patients with IBD.…”

“…In a cross-sectional study of 182 CD patients and 62 healthy controls, serum 25(OH) D was inversely associated with disease activity. 52 …”

Vitamin D as a novel therapy in inflammatory bowel disease: new hope or false dawn?

“…An open-label study from 2009, designed to examine the effects of vitamin D on bone markers in CD (n 37) (46) also captured effects on disease activity. Patients were treated with either active vitamin D or 25 μg (1000 IU) D 3 daily for 12 months; the authors reported a significant short-term reduction (42) 2013 Australia 40 X (HBI) X √ inverse Jorgensen et al (78) 2013 Denmark 182 √ inverse (CDAI) X -Kelly et al (66) 2011 Ireland 75 X (CDAI) X -Ulitsky et al (79) 2011 USA 403 √ inverse (HBI) --(total n∼785) Other disease outcomes Ananthakrishnan et al (44) 2013 USA 1769 Low 25(OH)D and higher risk of surgery and hospitalisation Zator et al (45) 2013 USA in disease activity (CDAI and CRP) with a more pronounced effect noted for the active form of vitamin D (46) . More recently, Yang et al (47) applied a protocol designed to focus on achieving circulating 25(OH)D levels of 100 nmol/l rather than on administrating a predefined fixed daily dose of vitamin D. In this small study (n 18), patients with mild to moderately active CD were supplemented with oral vitamin D 3 ; this dose was initiated at 25 μg (1000 IU) daily and escalated up to a maximum of 125 μg (5000 IU), to achieve the target circulating 25(OH)D of 100 nmol/l.…”

Optimal vitamin D levels in Crohn's disease: a review

“…Some studies have reported no difference in 25(OH)D-based disease activity, (31,42) whereas Jorgensen et al reported low levels were associated with active disease (43) . A clear trend of decreasing 25(OH)D from remission (64 nmol/l) to mild disease (49 nmol/l) and moderately active disease (21 nmol/l) (P < 0·01) was reported (43) . A recent study confirmed these findings insofar as patients with active Crohn's disease had lower 25(OH)D levels than those in clinical remission; this measurement was independent of season or reported supplement use (44) .…”