Association between vitamin D deficiency and anemia in inflammatory bowel disease patients with ileostomy

Abstract

Background Vitamin D deficiency is commonly seen in patients with inflammatory bowel disease (IBD). Vitamin D deficiency in IBD patients with ileostomy has not been systemically studied. The aim of the study was to assess the frequency and risk factors associated with low 25(OH) D3 levels in those patients. Methods 112 eligible IBD patients with ileostomy were studied. Demographic, clinical, and endoscopic variables were analyzed. Vitamin D levels before and after ileostomy were compared when available. Levels of serum 25(OH)D3 <20 ng/mL were classed as being deficient. Results 112 eligible ileostomy patients were included. The mean vitamin D level was 21.47 ± 1.08 ng/dl. Low levels of vitamin D (<30 ng/dl) were present in 92 patients (82%). Vitamin D deficiency (<20 ng/dL) was seen in 55 patients (49%). There was no difference between patients with or without vitamin D deficiency regarding demographic variables, medication use and duration of ileostomy. Neo-ileal inflammation on endoscopy was not associated with vitamin D deficiency (p = 0.155). Lower levels of phosphorus (p = 0.020) or hemoglobin (p = 0.019) and shorter duration of IBD (p = 0.047) were found in patients with vitamin D deficiency. In multivariate analysis, lower levels of phosphorus (odds ratio [OR]: 1.83, 95% confidence interval [CI]: 1.16–2.89, p = 0.009) and hemoglobin (OR: 1.32, 95% CI: 1.08–1.60, p = 0.006) remained significantly associated with vitamin D deficiency. Conclusion Vitamin D deficiency is common in IBD patients with ileostomy and is associated with low hemoglobin levels. Further studies are needed to evaluate vitamin D supplementation as a possible adjuvant in the treatment of anemia of chronic disease in IBD patients.

The Role of Vitamin D in Inflammatory Bowel Disease: Mechanism to Management

“…Aside from the well recognised skeletal effects, there is growing evidence for IBD disease outcome benefits from the normalisation of 25-OH-D serum levels in people with IBD. Benefits include: reduced risk of surgery in those with CD [12], reduction in inflammatory markers [69], reduction in the development of anemia [112], improved response to anti-TNF alpha treatment [111], and a reduction in the risk of colo-rectal cancer [105]. One study revealed a reduction in upper respiratory tract infections [91].…”

Effects of iron on Vitamin D metabolism: A systematic review

“…This pro-inflammatory mediator is involved in anemia of chronic disease. [34] Previous studies have reported beneficial effects of supplementation with Vitamin D on the reduction of erythropoiesis stimulating agents requirements in patients with chronic kidney disease and increased Hb concentrations. [3536] In a 16-week randomized controlled trial, Toxqui et al .…”

The Association Between Ferritin and Vitamin D Levels in Premenopausal Fibroid Uterus Cases With Anemia

“…Vitamin D influences iron metabolism and erythropoiesis, whereas iron is essential for vitamin D synthesis as well [9]. In terms of anemia, some studies have reported that ferritin levels are positively associated with serum vitamin D [10][11][12]. Though the existing scientific data indicates the role of vitamin D in fibroid uterus cases, the co-existence of anemia with vitamin D deficiency and the association between ferritin and vitamin D levels in premenopausal women with fibroid uterus are still not fully understood.…”