Predictors of vitamin D deficiency in inflammatory bowel disease and health: A Mississippi perspective

Abstract

AIMTo identify the predictors of vitamin D deficiency in patients with and without inflammatory bowel disease (IBD).METHODSPatients with ulcerative colitis (UC) or Crohn’s disease (CD) related diagnostic codes who received medical care at University of Mississippi Medical Center between July 2012 and 2015 were identified. After thorough chart review, we identified patients with biopsy proven IBD who had also been tested for serum 25-hydroxyvitamin D [25(OH)D] concentration. We compared these patients to a previously studied cohort of healthy controls who also had vitamin D concentration checked. Logistic regression analysis was performed to determine the association between vitamin d deficiency and UC, CD, race, age, gender and body mass index (BMI).RESULTSWe identified 237 patients with confirmed IBD. Of these, only 211 had a serum 25(OH)D concentrations available in the medical record. The group of healthy controls consisted of 98 individuals with available serum 25(OH)D concentration. 43% of IBD patients were African American (AA). Patients with CD were more likely to have vitamin D concentration checked. Bivariate analysis showed that AA (51% vs 21%, P = 0.00001), subjects with BMI >30 kg/m2 (39% vs 23% P = 0.01) and CD (40% vs 26%, P = 0.04) were more likely to be vitamin D deficient than vitamin D sufficient. Those with Age > 65 were more likely to be vitamin D sufficient (46% vs 15%, P = 0.04). Multiple regression showed that only BMI > 30 kg/m2 and AA race are associated with vitamin D deficiency.CONCLUSIONBMI > 30 kg/m2 and AA race are predictive of vitamin D deficiency. Gender, age and diagnosis of IBD are not predictive of vitamin D deficiency.

Seasonal variability of vitamin D status in patients with inflammatory bowel disease – A retrospective cohort study

“…Vitamin D deficiency is highly prevalent in IBD patients, at least in northern and middle Europe, and affects up to 63% of patients [4, 16], which is consistent with the high prevalence of 60% reported in this retrospective cohort study. Several risk factors have been associated with a risk of vitamin D deficiency including age at diagnosis, season of the year, long disease duration, smoking, CD activity, female gender, non-Caucasian ethnicity and limited sunshine exposure [11, 13, 16, 18, 20–22]. Higher 25(OH)D concentrations correlate with decreased risk to develop IBD-related complications and better outcomes of TNF-inhibitor therapy [8, 15, 19].…”

The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD

“…Furthermore, with specific attention to vitamin D, it is possible to identify many other factors affecting vitamin D serum levels; some of them are linked with the environment, such as the season or the latitude, while others correlate with some specific patient characteristics, like age, gender or anthropometric values [37,38]. In the specific case of IBD, analyzing vitamin D levels while taking environmental factors into consideration reveals in many studies that vitamin D levels are higher in summer than in winter, and that the incidence of hypovitaminosis D is higher in the Northern than in the Southern population [1,2,21,27,39,40].…”

Vitamin D deficiency in outpatients with inflammatory bowel disease: prevalence and association with clinical-biological activity

“…A few other variables have been associated with low levels of vitamin D in IBD. Notable among these are longstanding disease (36), age (19,32), sex, smoking (33,34), steroid use, obesity (35) and non-Caucasian race (22,35). As the great majority of patients in our series were Caucasian, we are unable to assess this aspect.…”