The Vitamin D Status in Inflammatory Bowel Disease

Abstract

ContextThere is no consensus on the vitamin D status of children and adolescents with inflammatory bowel disease (IBD).AimTo determine the vitamin D status of patients with IBD by comparing their serum 25(OH)D concentration to that of healthy controls.HypothesisSerum 25(OH)D concentration will be lower in patients with IBD compared to controls.Subjects and MethodsA case-controlled retrospective study of subjects with IBD (n = 58) of 2–20 years (male n = 31, age 16.38±2.21 years; female n = 27, age16.56±2.08 years) and healthy controls (n = 116; male n = 49, age 13.90±4.59 years; female n = 67, age 15.04±4.12years). Study subject inclusion criteria: diagnosis of Crohn’s disease (CD) or ulcerative colitis (UC). Vitamin D deficiency was defined as 25(OH)D of (<20 ng/mL) (<50 nmol/L), overweight as BMI of ≥85th but <95th percentile, and obesity as BMI ≥95th percentile. Data were expressed as mean ± SD.ResultsPatients with CD, UC, and their controls had mean serum 25(OH)D concentrations of 61.69±24.43 nmol/L, 53.26±25.51, and 65.32±27.97 respectively (ANOVA, p = 0.196). The overweight/obese controls had significantly lower 25(OH)D concentration compared to the normal-weight controls (p = 0.031); whereas 25(OH)D concentration was similar between the normal-weight and overweight/obese IBD patients (p = 0.883). There was no difference in 25(OH)D between patients with UC and CD, or between subjects with active IBD and controls. However, IBD subjects with elevated ESR had significantly lower 25(OH)D than IBD subjects with normal ESR (p = 0.025), as well as controls (65.3±28.0 nmol/L vs. 49.5±25.23, p = 0.045).ConclusionThere is no difference in mean serum 25(OH)D concentration between children and adolescents with IBD and controls. However, IBD subjects with elevated ESR have significantly lower 25(OH)D than controls. Therefore, IBD subjects with elevated ESR should be monitored for vitamin D deficiency.

Anaemia in the Elderly IBD Patient

“…Surprisingly, the identified prevalence of vitamin D deficiencies was lower than reported in other studies of adults with IBD, although this may be due to the use of different cut-offs [24,25].…”

Hypovitaminosis D and Low Bone Mineral Density in Inflammatory Bowel Disease Patients

“…Data in the literature do not agree on the relationship between the ileal involvement in CD and deficiency of vitamin D. Some authors report an association between hypovitaminosis and ileal disease [21,29], while others did not find such correlation [19,25,30]. Our data are consistent with recent studies of Crohn's disease, demonstrating on the contrary a positive trend between hypovitaminosis and the extent of disease in ulcerative colitis.…”

“…There are few studies in the literature about the relationship between BMI and hypovitaminosis D. These tend to consider the relationship between normal or increased BMI and levels of vitamin D, showing a correlation between high BMI and hypovitaminosis D [19]. In our study, however, we have noticed a correlation between BMI and values of vitamin D, while the reduced values of BMI correlate with an alteration of bone densitometry, as reported by other studies which have addressed this relationship [31].…”

“…This lack of correlation has been reported in the literature by several authors [18,19] who, among other mechanisms, also suggest a possible important role of vitamin D at the intestinal level that would allow a greater absorption of vitamin D secondary to the beneficial effects of a longer therapy and therefore a better control of the activity of the disease itself. In contrast, other authors have found an inverse correlation between the duration of disease and serum levels of vitamin D, especially in patients with Crohn's disease [20].…”

Association Between Inflammatory Bowel Disease and Vitamin D Deficiency

“…Evidence from observational studies remains questionable, as some studies report lower circulating vitamin D levels in IBD 27–43 , while others 44–53 do not. Given the lack of clarity regarding the association of vitamin D deficiency with IBD, we decided to conduct a systematic review and meta-analysis of observational studies looking at the association of IBD and its subtypes with vitamin D deficiency.…”