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

Abstract

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

“…In fact, different prevalence rates of vitamin D deficiency were published, namely 16-95% [6][7][8][9][10][11][12][13][14], but the later studies, which include a systematic review [15], reported high prevalence rates. Our study is in accordance with the most recent data, revealing a prevalence of 68% of vitamin D deficiency, and almost one-fifth of patients had a severe deficiency, with only around 9% of patients having adequate levels of vitamin D. In comparison with the 2 published Portuguese studies [6,7], this prevalence lies in between, which can be explained by the differences in the inclusion criteria: our study included patients with IBD in different clinical settings, while one of the studies included just outpatients [6] and the other included only patients with more severe disease [7]. The mean values of vitamin D assessed in our study, 17.1 ± 8 ng/mL, were classified as deficient.…”

“…These results suggest that low levels of vitamin D are linked to high disease activity. There is no consensus on this issue in the literature, although many studies have already reported a relation between low levels of vitamin D and more clinical activity [6,[16][17][18][19][20][21], while others have not [22][23][24]. This relation is more consistently reproduced when activity is subjectively measured, by clinical indices, than when activity is objectively measured, by systemic inflammation markers, such as CRP or ESR (as fecal calprotectin is measured in almost none of the studies).…”

“…Vitamin D deficiency has also been reported in these patients, although published data are conflicting as the prevalence of vitamin D deficiency in patients with IBD ranges from 16 to 95% [6][7][8][9][10][11][12][13][14]. It is also not clear in which type of IBD the prevalence of vitamin D deficiency is higher [8,15].…”

“…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.…”

“…There are 2 published Portuguese studies on this subject, both from the north of the country. Castro et al [6] encountered a prevalence of vitamin D deficiency of 30% (samples were collected in the summer and patients included were only in ambulatory care) in a cohort of 76 patients with IBD, particularly in those with CD, and found a correlation between lower levels of vitamin D and higher disease activity and worse quality of life. Santos-Antunes et al [7] included 68 patients with IBD with indication to start anti-TNF therapy and found a prevalence of vitamin D deficiency of 93%.…”