Vitamin D Deficiency Associated with Disease Activity in Patients with Inflammatory Bowel Diseases

Torki, Mehdi; Gholamrezaei, Ali; Mirbagher, Leila; Danesh, Manijeh; Kheiri, Sara

doi:10.1007/s10620-015-3727-4

Cited by 68 publications

(54 citation statements)

References 43 publications

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“…In concordance, both the National Geriatric Society and International Osteoporosis Foundation recommend maintaining serum 25(OH)D .30 ng/mL, a concentration at which parathyroid hormone concentrations begin to plateau in relation to 25(OH)D (39)(40)(41). Although these categorical recommendations for defining vitamin D deficiency and sufficiency are mainly based on investigations focused on bone metabolism, most studies to our knowledge that have examined patients with IBD have used a similar definition of a 25(OH)D concentration ,20 ng/mL to represent vitamin D deficiency (12,14,31,(42)(43)(44).…”

Section: Discussionmentioning

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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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%

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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“…One study reports that patients with UC had more than double the odds of vitamin D deficiency when compared with normal controls (OR = 2.28; 95% CI: 1.18–4.41; I = 41%; p = 0.01) [47]. There is also evidence to suggest that vitamin D deficiency may influence the severity of inflammation in IBD [48,49,50]. A cross-sectional study revealed that subjects with active disease had more frequent low vitamin D levels (80% vs. 50.4%, p = 0.005) when compared to subjects in remission [49].…”

Section: Pharmaconutritionmentioning

confidence: 99%

“…There is also evidence to suggest that vitamin D deficiency may influence the severity of inflammation in IBD [48,49,50]. A cross-sectional study revealed that subjects with active disease had more frequent low vitamin D levels (80% vs. 50.4%, p = 0.005) when compared to subjects in remission [49]. A large prospectively collected cohort of 230 subjects demonstrated 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) in subjects with UC [48].…”

Section: Pharmaconutritionmentioning

confidence: 99%

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

Haskey

Gibson

2017

Nutrients

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Diet has been speculated to be a factor in the pathogenesis of inflammatory bowel disease and may be an important factor in managing disease symptoms. Patients manipulate their diet in attempt to control symptoms, often leading to the adoption of inappropriately restrictive diets, which places them at risk for nutritional complications. Health professionals struggle to provide evidence-based nutrition guidance to patients due to an overall lack of uniformity or clarity amongst research studies. Well-designed diet studies are urgently needed to create an enhanced understanding of the role diet plays in the management of inflammatory bowel disease. The aim of this review is to summarize the current data available on dietary management of inflammatory bowel disease and to demonstrate that dietary modulation may be an important consideration in managing disease. By addressing the relevance of diet in inflammatory bowel disease, health professionals are able to better support patients and collaborate with dietitians to improve nutrition therapy.

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“…An explanation for this might be the fact that the mean SCCAI in the cohort of UC patients studied was overall low and only very few patients had evidence of active disease. There is evidence from various studies that vitamin D levels are lower in patients with active disease [5,9,22,23]. One study demonstrates that patients with UC with low baseline vitamin D levels were also more likely to suffer from disease relapse over months [24].…”

Section: Discussionmentioning

confidence: 99%

Vitamin D and Ulcerative Colitis: Is There a Relationship with Disease Extent?

Zammit

Schembri

Pisani

et al. 2018

Dig Dis

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Introduction: Patients with ulcerative colitis (UC) can suffer from low serum vitamin D that can result in complications such as low bone mineral density. It can also reflect underlying disease severity. Methods: One hundred and ninety-seven patients previously diagnosed with UC from 2 European centers were prospectively recruited through the out-patient clinics. Clinical features (Montreal Classification, age, gender, previous and current medications, surgery), disease activity (Simple Clinical Colitis Activity Index [SCCAI]), blood investigations including serum inflammatory markers, and serum vitamin D were analyzed. The vitamin D levels were compared to a group of age- and gender-matched healthy controls. Results: Mean vitamin D levels were lower in patients with UC (54.6 nmol/L) than in controls (80.7 nmol/L; p = 0.0001). Mean vitamin D levels was lowest in patients with extensive UC (E3; p = 0.0001). Serum vitamin D was not significantly different across treatment groups (p = 0.876). There was no statistical difference in vitamin D levels across patients receiving calcium and vitamin D supplements (p = 0.35) and there was no statistical correlation with SCCAI (p = 0.22). Conclusions: This study confirms the existence of low serum vitamin D in patients with UC when compared to healthy controls. It also provides evidence of an existing relationship between disease extent and serum vitamin D.

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Vitamin D Deficiency Associated with Disease Activity in Patients with Inflammatory Bowel Diseases

Abstract: We found an association between vitamin D deficiency/insufficiency and disease activity in IBD patients. Prospective cohorts and clinical trials are required to clarify the role of vitamin D deficiency and its treatment in clinical course of IBD.

Cited by 68 publications

References 43 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,

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

Vitamin D and Ulcerative Colitis: Is There a Relationship with Disease Extent?

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