Hypovitaminosis D in Adults with Inflammatory Bowel Disease: Potential Role of Ethnicity

Fu, Nancy; Chatur, Nazira; Cheong-Lee, Cindy; Salh, Baljinder

doi:10.1007/s10620-012-2130-7

Cited by 44 publications

(37 citation statements)

References 31 publications

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“…Previous studies have reported a high incidence of vitamin D deficiency in patients with IBD (9)(10)(11)31). In Crohn disease, several groups have demonstrated an association between vitamin D and clinical disease activity (12)(13)(14).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Northern Hemisphere populations that reside at higher latitudes where daily sunlight exposure is lower have a higher prevalence of IBD, particularly Crohn disease (4,5). Previous analyses have also reported a high prevalence of vitamin D deficiency in patients with both Crohn disease and UC (6)(7)(8)(9)(10)(11). Furthermore, several studies have demonstrated an inverse correlation between clinical symptoms and serum vitamin concentrations in patients with Crohn disease (12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

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Serum 25-hydroxyvitamin D concentration is inversely associated with mucosal inflammation in patients with ulcerative colitis,

Meckel¹,

Li²,

Lim³

et al. 2016

The American Journal of Clinical Nutrition

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Background: Vitamin D exerts anti-inflammatory actions both in vitro and in murine models of colitis. In previous studies, we demonstrated that vitamin D protects against the development of colitis by maintaining the integrity of the intestinal mucosal barrier. Objective: We sought to evaluate whether deficient serum 25 hydroxyvitamin D [25(OH)D] concentrations are associated with increased mucosal inflammation, a loss of epithelial junctional proteins, and an increase in mucosal inflammatory cytokines in patients with ulcerative colitis (UC). Design: We prospectively enrolled 230 subjects with UC. Serum 25(OH)D concentrations were compared with the Mayo endoscopic score, the total Mayo score, and histologic activity. Colonic mucosal expression concentrations of vitamin D receptor (VDR), E-cadherin, zonula occluden 1 (ZO-1), occludin, claudin-2, tumor necrosis factor a (TNF-a), and interleukin 8 (IL-8) were compared between dichotomous groups with low or high serum 25(OH)D concentrations. Results: The mean serum 25(OH)D concentration was 21.8 ng/mL. Subjects stratified by concentrations included 12.6% $30 ng/mL, 45.6% $20 to ,30 ng/mL, 37.4% $10 to ,20 ng/mL, and 4.4% ,10 ng/mL. There was an inverse association between serum 25(OH)D concentrations and mucosal inflammation as assessed by the Mayo endoscopy score (P = 0.01), disease activity as indicated by the total Mayo score (P = 0.001), and histologic activity (P = 0.02). A serum 25(OH)D concentration ,20 ng/mL was associated with decreased mucosal transcript and protein expression concentrations of VDR, E-cadherin, and occludin as well as decreased protein expression of ZO-1, whereas TNF-a and IL-8 mucosal transcript expression concentrations were increased. Conclusions: In UC patients, serum 25(OH)D concentration is inversely correlated with mucosal inflammation and disease activity. These results, coupled with the findings that serum 25(OH)D concentrations correlate with the mucosal expression of VDR as well as epithelial junction proteins and inversely with proinflammatory cytokines, suggest that vitamin D deficiency may contribute to UC inflammation by disrupting epithelial barrier function.Am J Clin Nutr 2016;104:113-20.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serum 25-hydroxyvitamin D concentration is inversely associated with mucosal inflammation in patients with ulcerative colitis,

Meckel¹,

Li²,

Lim³

et al. 2016

The American Journal of Clinical Nutrition

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“…It included 14 studies with a total of 1,891 patients and reported that patients with IBD had 64% higher odds of vitamin D deficiency when compared with controls [15]. An association with disease activity has been described more inconsistently, with some authors arguing that there is a relation between lower levels of vitamin D and higher disease activity [6,[16][17][18][19][20][21], while others have not found any relation [22][23][24]. There are 2 published Portuguese studies on this subject, both from the north of the country.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D Deficiency in a Portuguese Cohort of Patients with Inflammatory Bowel Disease: Prevalence and Relation to Disease Activity

Branco

Cardoso

Anapaz

et al. 2018

GE Port J Gastroenterol

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Background and Aims: Vitamin D deficiency is more common in inflammatory bowel disease (IBD) patients than in the general population. However, there are conflicting data about predictive factors of vitamin D deficiency and its potential association with disease activity. The aims of this study were to determine the prevalence and predictive factors of vitamin D deficiency and to evaluate a possible association with disease activity. Methods: A prospective observational study was conducted, including patients with IBD from January to July 2016. The Endocrine Society guidelines were considered for defining levels of serum 25-hydroxyvitamin D (25-OH-D) as follows: deficient (< 20 ng/mL, < 10 ng/mL being severe deficiency), insufficient (21–29 ng/mL), and adequate (> 30 ng/mL). Results: A total of 152 patients (52% men; 47.2 ± 17.3 years) were included, of whom 70% had Crohn’s disease (CD). Thirty-seven percent of patients were on immunosuppressors and 17% were on biologics. The majority were outpatients (88.2%). Mean 25-OH-D levels were 17.1 ± 8 ng/mL (CD: 16.7 ± 8 ng/mL vs. ulcerative colitis: 17.6 ± 7 ng/mL, p = 0.1). Inadequate levels were present in 90.8% of patients (deficiency: 68.4%; insufficiency: 22.4%). A significant negative correlation between 25-OH-D levels and age (r = –0.2, p = 0.04), C-reactive protein (CRP) levels (r = –0.22, p = 0.004), and Harvey-Bradshaw index (HBi) (r = –0.32, p = 0.001) was found. Patients with severe deficiency showed a higher CRP (0.6 vs. 1.4 mg/dL, p = 0.03), erythrocyte sedimentation rate (ESR) (22 vs. 31 mm/h, p = 0.03), and HBi (2 vs. 5, p < 0.001) and lower hemoglobin (13.6 vs. 12.7 g/dL, p = 0.02). There was no association between vitamin D deficiency and gender, type, extent, and duration of disease, surgery, and other measures of disease activity, such as ESR, hemoglobin (these 2 items except for severe deficiency), fecal calprotectin, or Truelove and Witts classification. Conclusions: There is a high prevalence of inadequate levels of vitamin D in IBD patients, particularly deficiency (68.4%). There seems to exist an association between lower levels of vitamin D and higher disease activity, especially in CD.

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“…Clinically, increasing 25(OH)D levels through high-dose vitamin D supplementation may have therapeutic potential and prevent relapse in CD (17,18) , although this still warrants confirmation in controlled trials. Several studies have been conducted to demonstrate a correlation between vitamin D status and inflammatory bowel disease activity (6,14) . However, few studies (33) have so far hypothesized that vitamin D deficiency is associated with a lower quality of life (QOL) in patients with IBD.…”

Section: Introductionmentioning

confidence: 99%

Lower Levels of Vitamin D Correlate With Clinical Disease Activity and Quality of Life in Inflammatory Bowel Disease

Castro

Magalhães

Carvalho

et al. 2015

Arq. Gastroenterol.

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Hypovitaminosis D in Adults with Inflammatory Bowel Disease: Potential Role of Ethnicity

Cited by 44 publications

References 31 publications

Serum 25-hydroxyvitamin D concentration is inversely associated with mucosal inflammation in patients with ulcerative colitis,

Serum 25-hydroxyvitamin D concentration is inversely associated with mucosal inflammation in patients with ulcerative colitis,

Vitamin D Deficiency in a Portuguese Cohort of Patients with Inflammatory Bowel Disease: Prevalence and Relation to Disease Activity

Lower Levels of Vitamin D Correlate With Clinical Disease Activity and Quality of Life in Inflammatory Bowel Disease

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