Dynamics of vitamin D in patients with mild or inactive inflammatory bowel disease and their families

Abstract

Background25(OH) vitamin D levels may be low in patients with moderately or severely active inflammatory bowel diseases (IBD: Crohn’s disease and Idiopathic Ulcerative Colitis) but this is less clear in patients with mild or inactive IBD. Furthermore there is limited information of any family influence on 25(OH) vitamin D levels in IBD. As a possible risk factor we hypothesize that vitamin D levels may also be low in families of IBD patients.ObjectivesTo evaluate 25[OH] vitamin D levels in patients with IBD in remission or with mild activity. A second objective is to evaluate whether there are relationships within IBD family units of 25[OH] vitamin D and what are the influences associated with these levels.MethodsParticipants underwent medical history, physical examination and a 114 item diet questionnaire. Serum 25[OH] vitamin D was measured, using a radioimmunoassay kit, (replete ≥ 75, insufficient 50–74, deficient < 25–50, or severely deficient < 25 nmol/L). Associations between 25[OH] vitamin D and twenty variables were evaluated using univariate regression. Multivariable analysis was also applied and intrafamilial dynamics were assessed.Results55 patients and 48 controls with their respective families participated (N206). 25[OH] vitamin D levels between patients and controls were similar (71.2 ± 32.8 vs. 68.3 ±26.2 nmol/L). Vitamin D supplements significantly increased intake but correlation with serum 25[OH] vitamin D was significant only during non sunny months among patients. Within family units, patients’ families had mean replete levels (82.3 ± 34.2 nmol/L) and a modest correlation emerged during sunny months between patients and family (r2 =0.209 p = 0.032). These relationships were less robust and non significant in controls and their families.ConclusionsIn patients with mild or inactive IBD 25[OH] vitamin D levels are less than ideal but are similar to controls. Taken together collectively, the results of this study suggest that patient family dynamics may be different in IBD units from that in control family units. However contrary to the hypothesis, intra familial vitamin D dynamics do not pose additional risks for development of IBD.

Seasonal clustering in inflammatory bowel disease: a single centre experience

“…In this study, we evaluated seasonal clustering in newly diagnosed IBD patients with clinical complaints instead of the endoscopic diagnosis date as used in previously published studies [19][20][21][22] . In this context, we evaluated the seasonal variability in a large IBD cohort.…”

“…We found the lowest peak for CUC cases in autumn, and therefore enteric infections seem less favorable as a precipitating factor for CUC onset. Vitamin D is essential for functioning of the immune system [19,20] and regulates both adaptive and innate immunity in human. Turkey is a relatively sunny country compared with some western European or North American cities.…”

Association between 25(OH)D Level, Ultraviolet Exposure, Geographical Location, and Inflammatory Bowel Disease Activity: A Systematic Review and Meta-Analysis

“…Our study included 13 studies investigating the association between CD and vitamin D levels [ 17 , 18 , 20 – 30 ]. Of them, eight studies also referred to the relationship between UC and vitamin D levels[ 17 , 20 , 21 , 23 , 24 , 27 , 29 , 30 ]. Patients’ basic characteristics are presented in Table 1 .…”

“…The participants in three studies[ 18 , 20 , 21 ] were children, and those in the other studies were adults. In addition, eight studies were used to analyze dichotomous exposure (vitamin D deficiency) in CD[ 21 – 24 , 26 , 28 , 31 , 32 ], of which three studies also referred to UC[ 21 , 23 , 24 ]. Continuous variable can directly reflect the relationship between IBD and vitamin D levels, whereas dichotomous variables indicate morbidity of IBD under different vitamin D classifications.…”

“…In addition, eight reports described dichotomous variables for vitamin D deficiency in patients with CD [ 21 – 24 , 26 , 28 , 31 , 32 ]. Three studies investigated UC and vitamin D deficiency [ 21 , 23 , 24 ]( Table 2 ). CD patients were 1.95 times (OR = 1.95, 95% CI = 1.48–2.57, I 2 = 0, P = 0.866) more likely to suffer vitamin D deficiency than controls ( Fig 4 ).…”