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

Mentella, Maria Chiara; Scaldaferri, Franco; Pizzoferrato, Marco; Gasbarrini, Antonio; Miggiano, Giacinto Abele Donato

doi:10.3390/nu11112583

Cited by 34 publications

(24 citation statements)

References 59 publications

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“…This could be acknowledged as another limitation. Nevertheless, some other studies did not find a strong association between BMI and disease activity and prognosis[ 20 - 23 ], and this underlines how this topic is still debated and with conflicting evidences.…”

Section: Discussionmentioning

confidence: 95%

Prevalence and associated factors of obesity in inflammatory bowel disease: A case-control study

Losurdo¹,

Fortezza²,

Iannone³

et al. 2020

WJG

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BACKGROUND In recent years, an increasing prevalence of obesity in inflammatory bowel disease (IBD) has been observed. Obesity, moreover, has been directly correlated with a more severe clinical course and loss of response to treatment. AIM To assess the prevalence and associated factors of obesity in IBD. METHODS We collected data about IBD disease pattern and activity, drugs and laboratory investigations in our center. Anthropometric measures were retrieved and obesity defined as a body mass index (BMI) > 30. Then, we compared characteristics of obese vs non obese patients, and Chi-squared test and Student’s t test were used for discrete and continuous variables, respectively, at univariate analysis. For multivariate analysis, we used binomial logistic regression and estimated odd ratios (OR) and 95% confidence intervals (CI) to ascertain factors associated with obesity. RESULTS We enrolled 807 patients with IBD, either ulcerative colitis (UC) or Crohn’s disease (CD). Four hundred seventy-four patients were male (58.7%); the average age was 46.2 ± 13.2 years; 438 (54.2%) patients had CD and 369 (45.8%) UC. We enrolled 378 controls, who were comparable to IBD group for age, sex, BMI, obesity, diabetes and abdominal circumference, while more smokers and more subjects with hypertension were observed among controls. The prevalence of obesity was 6.9% in IBD and 7.9% in controls (not statistically different; P = 0.38). In the comparison of obese IBD patients and obese controls, we did not find any difference regarding diabetes and hypertension prevalence, nor in sex or smoking habits. Obese IBD patients were younger than obese controls (51.2 ± 14.9 years vs 60.7 ± 12.1 years, P = 0.03). At univariate analysis, obese IBD were older than normal weight ones (51.2 ± 14.9 vs 44.5 ± 15.8, P = 0.002). IBD onset age was earlier in obese population (44.8 ± 13.6 vs 35.6 ± 15.6, P = 0.004). We did not detect any difference in disease extension. Obese subjects had consumed more frequently long course of systemic steroids (66.6% vs 12.5%, P = 0.02) as well as antibiotics such as metronidazole or ciprofloxacin (71.4% vs 54.7%, P = 0.05). No difference about other drugs (biologics, mesalazine or thiopurines) was observed. Disease activity was similar between obese and non obese subjects both for UC and CD. Obese IBD patients suffered more frequently from arterial hypertension, type 2 diabetes, non-alcoholic fatty liver disease. Regarding laboratory investigations, obese IBD patients had higher levels of triglyceridemia, fasting blood glucose, gamma-glutamyl-transpeptidase. On multivariate analysis, however, t...

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Section: Discussionmentioning

confidence: 95%

Prevalence and associated factors of obesity in inflammatory bowel disease: A case-control study

Losurdo¹,

Fortezza²,

Iannone³

et al. 2020

WJG

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“…Supplementation of vitamin D in IBD patients is challenging due to nutrients malabsorption issues, and higher doses are often necessary to achieve the recommended circulating level (above 20 ng/mL, according to IOM) [ 70 ]. Nevertheless, it seemed to be a promising complementary treatment that may improve inflammation markers, such as high-sensitivity C-reactive protein (hs-CRP) and erythrocyte sedimentation rate (ESR), suppressing the Th1 immune response, while reduced clinical disease activity index [ 14 , 80 , 81 , 82 , 83 , 84 , 85 , 86 ].…”

Section: Vitamin D Critical Role In Ibdmentioning

confidence: 99%

Vitamin D Modulates Intestinal Microbiota in Inflammatory Bowel Diseases

Battistini

Ballan

Herkenhoff

et al. 2020

IJMS

103

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Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal tract (GIT), including Crohn’s disease (CD) and ulcerative colitis (UC), which differ in the location and lesion extensions. Both diseases are associated with microbiota dysbiosis, with a reduced population of butyrate-producing species, abnormal inflammatory response, and micronutrient deficiency (e.g., vitamin D hypovitaminosis). Vitamin D (VitD) is involved in immune cell differentiation, gut microbiota modulation, gene transcription, and barrier integrity. Vitamin D receptor (VDR) regulates the biological actions of the active VitD (1α,25-dihydroxyvitamin D3), and is involved in the genetic, environmental, immune, and microbial aspects of IBD. VitD deficiency is correlated with disease activity and its administration targeting a concentration of 30 ng/mL may have the potential to reduce disease activity. Moreover, VDR regulates functions of T cells and Paneth cells and modulates release of antimicrobial peptides in gut microbiota-host interactions. Meanwhile, beneficial microbial metabolites, e.g., butyrate, upregulate the VDR signaling. In this review, we summarize the clinical progress and mechanism studies on VitD/VDR related to gut microbiota modulation in IBD. We also discuss epigenetics in IBD and the probiotic regulation of VDR. Furthermore, we discuss the existing challenges and future directions. There is a lack of well-designed clinical trials exploring the appropriate dose and the influence of gender, age, ethnicity, genetics, microbiome, and metabolic disorders in IBD subtypes. To move forward, we need well-designed therapeutic studies to examine whether enhanced vitamin D will restore functions of VDR and microbiome in inhibiting chronic inflammation.

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“…An observational study with 206 IBD patients showed that vitamin D deficiency and insufficiency were observed in both CD and UC patients, but were more frequent in CD patients. In addition, moderate and severe clinical disease activities reported were significantly associated with vitamin D deficiency in CD [86]. Similarly, Mechie et al reported that the majority of IBD patients had vitamin D deficiency and the serum levels of 25(OH)D may be considered an important marker for IBD disease activity, in addition to hs-CRP and fecal calprotectin [87].…”

Section: Vitamin D and Gut Microbiota Modulationmentioning

confidence: 97%

Vitamin D Modulates Intestinal Microbiota in Inflammatory Bowel Diseases

Battistini¹,

Ballan²,

Herkenhoff³

et al. 2020

Preprint

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Inflammatory bowel disease (IBD) is a chronic disease in the gastrointestinal tract (GIT). IBD include ulcerative colitis (UC), which generally affects only the large intestine mucosa and submucosa, and Crohn’s disease (CD), which may affect any part of the GIT by transmural inflammation. Both UC and CD are associated with an imbalance of the gut microbiota composition and injuries in the intestinal mucosa. The intestinal dysbiosis is related to a reduction in butyrate-producing species, impairing the anti-inflammatory response of the immune system, and is commonly associated with micronutrients deficiency, e.g. vitamin D hypovitaminosis. Vitamin D is involved in several critical functions, including immune cell differentiation, regulation of microbiota, gene transcription, and barrier integrity. Vitamin D supplementation in IBD patients showed promising results in reducing the disease activity and modulating gut microbiota. Vitamin D receptor (VDR) regulates the biological actions of the active vitamin D metabolite, 1α,25-dihydroxyvitamin D3. Evidence supports that the VDR signaling is involved in the genetic, environmental, immune, and microbial aspects of IBD. Low VDR expression and dysfunction of vitamin D/VDR signaling are reported in IBD patients. Vitamin D/VDR deficiency could be considered as a multifunctional susceptibility factor in IBD. Therefore, in this review, we will discuss the progress in clinical studies, mechanism studies on Vitamin D /VDR, and potential use of vitamin D supplementation as adjuvant therapy to restore gut microbiota balance, promote beneficial metabolites, and inhibit inflammation status in patients with IBD.

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

Cited by 34 publications

References 59 publications

Prevalence and associated factors of obesity in inflammatory bowel disease: A case-control study

Prevalence and associated factors of obesity in inflammatory bowel disease: A case-control study

Vitamin D Modulates Intestinal Microbiota in Inflammatory Bowel Diseases

Vitamin D Modulates Intestinal Microbiota in Inflammatory Bowel Diseases

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