Vitamin D deficiency in a European inflammatory bowel disease inception cohort: an Epi-IBD study

Zammit, Stefania Chetcuti; Ellul, Pierre; Girardin, Giulia; Valpiani, D.; Nielsen, K R; Olsen, J; Goldiş, Adrian; Lazăr, Daniela; Shonová, Olga; Novàkovâ, Marie; Sebastian, Shaji; Whitehead, Emma; Carmona, Amalia; Martínez-Cadilla, Jesús; Dahlerup, Jens Frederik; Kievit, Adriana L H; Thorsgaard, Niels; Κατσάνος, Κωνσταντίνος; Christodoulou, Dimitrios; Magro, Fernando; Salupere, Riina; Pedersen, Natalia; Kjeldsen, Jens; Carlsen, Katrine; Ioannis, Kaimaklioti; Bergemalm, Daniel; Halfvarson, Jonas; Ďuricová, Dana; Bortlík, Martin; Collin, Pekka; Oksanen, Pia; Kiudelis, Gediminas; Kupčinskas, Limas; Kudsk, Karen; Andersen, Vibeke; O’Moráin, Colm; Bailey, Yvonne; Schwartz, Doron; Odes, Shmuel; Almér, Sven; Arebi, Naila; Misra, Ravi; Čuković‐Čavka, Silvija; Brinar, Marko; Munkholm, Pia; Végh, Zsuzsanna; Burisch, Johan

doi:10.1097/meg.0000000000001238

Cited by 29 publications

(27 citation statements)

References 45 publications

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“…on 504 IBD patients, of which 80% had been diagnosed with CD, 49.8% were vitamin D deficient ( 23 ). Analysis of vitamin D deficiency in an epidemiological collaboration amongst centers across Europe (Epi-IBD study) including a cohort of 238 patients revealed a prevalence of vitamin D deficiency of 65.4% in CD and 53.7% in UC, and vitamin D insufficiency of 17.3% in CD and 22.3% in UC ( 25 ). Zullow et al .…”

Section: Discussionmentioning

confidence: 99%

“…showed association of vitamin D deficiency with mucosal inflammation and disease activity in UC patients ( 30 ). In addition, clinical and biochemical disease activity has also been reported as a factor associated with vitamin D deficiency ( 25 , 31 ). However, in a retrospective study in a single northern German IBD cohort, patients were stratified according to clinical disease activity into highly active (HBI >9 or Simple Clinical Colitis Activity Index (SCCAI) >6) and those in remission (HBI 0-3 or SCCAI 0-2).…”

Section: Discussionmentioning

confidence: 99%

“…Also, patients with vitamin D sufficiency had the highest percentage of enteral nutrition supplementation. The Epi-IBD study indicated improvement of vitamin D levels owing to successful disease control rather than supplementation therapy ( 25 ). If there is inflammation at the site of vitamin D absorption, control of inflammation could improve vitamin D absorption.…”

Section: Discussionmentioning

confidence: 99%

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High Prevalence of Untreated and Undertreated Vitamin D Deficiency and Insufficiency in Patients with Inflammatory Bowel Disease

2020

ACC

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-Inflammatory bowel disease (IBD) patients with vitamin D deficiency show an increased risk of hospital admission, surgery, and loss of response to biologic therapy while high vitamin D levels are identified as a protective factor. Our goal was to investigate the prevalence of untreated and undertreated vitamin D deficiency and factors associated with vitamin D deficiency. In this cross-sectional study, we measured serum vitamin D in a random sample of Caucasian IBD patients. Vitamin D deficiency was defined as <50 nmol/L and insufficiency as 50-75 nmol/L. Supplementation was defined as taking 800-2000 IU vitamin D daily. Untreated patients were defined as not taking supplementation and undertreated group as receiving supplementation but showing vitamin D deficiency or insufficiency despite treatment. Our study included 185 IBD patients, i.e. 126 (68.1%) with Crohn's disease (CD) and 59 (31.9%) with ulcerative colitis (UC). Overall, 108 (58.4%) patients had vitamin D deficiency and 60 (32.4%) patients vitamin D insufficiency. There were 16 (14.8%) and 11 (18.3%) treated patients in vitamin D deficiency and vitamin D insufficiency group, respectively. The rate of untreated patients was 81.7% (n=49) in vitamin D deficiency group and 85.2% (n=92) in vitamin D insufficiency group. Tumor necrosis factor alpha inhibitors were associated with higher serum vitamin D levels in CD and UC, and ileal involvement, ileal and ileocolonic resection with lower levels. In conclusion, not only is vitamin D deficiency common in IBD patients but the proportion of untreated and undertreated patients is considerably high. We suggest regular monitoring of vitamin D levels in IBD patients regardless of receiving vitamin D supplementation therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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High Prevalence of Untreated and Undertreated Vitamin D Deficiency and Insufficiency in Patients with Inflammatory Bowel Disease

2020

ACC

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“…While its exact pathogenesis is still unclear, studies have shown IBD to be associated with genetic predisposition, combined with a complex variety of environmental influences (e.g., diet, smoking, sleep), in addition to microbial and immune factors [14][15][16]. Vitamin D deficiency is known to occur with increased prevalence in patients with Crohn's disease (CD) and ulcerative colitis (UC), the two predominant pathophysiological manifestations of IBD [17,18]. However, it has yet to be proven whether inadequate vitamin D status acts as a trigger or propagator of inflammation in IBD, whether the deficiency arises purely as a consequence of chronic inflammatory activity or whether there may be some aspects of both.…”

Section: Introductionmentioning

confidence: 99%

Measuring Vitamin D Status in Chronic Inflammatory Disorders: How does Chronic Inflammation Affect the Reliability of Vitamin D Metabolites in Patients with IBD?

Aksan

Hein

Boettger

et al. 2020

JCM

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Evidence gained from recent studies has generated increasing interest in the role of vitamin D in extraskeletal functions such as inflammation and immunoregulation. Although vitamin D deficiency has been implicated in the pathophysiology of inflammatory diseases including inflammatory bowel disease (IBD), evidence as to whether vitamin D supplementation may cure or prevent chronic disease is inconsistent. Since 25OH-vitamin D (25OHD) has been suggested to be an acute-phase protein, its utility as a vitamin D status marker is therefore questionable. In this study, possible interactions of vitamin D and inflammation were studied in 188 patients with IBD, with high-sensitivity C-reactive protein (hsCRP) levels ≥ 5 mg/dL and/or fecal calprotectin ≥ 250 µg/g defined as biochemical evidence of inflammatory activity. Levels of 25OHD and vitamin D-binding protein (VDBP) were determined by ELISA, and 1,25-dihydroxyvitamin D (1,25OHD) and dihydroxycholecalciferol (24,25OHD) by LC-MS/MS. Free and bioavailable vitamin D levels were calculated with the validated formula of Bikle. Serum 1,25OH2D and vitamin D binding protein (VDBP) levels were shown to differ between the inflammatory and noninflammatory groups: patients with inflammatory disease activity had significantly higher serum concentrations of 1,25OH2D (35.0 (16.4–67.3) vs. 18.5 (1.2–51.0) pg/mL, p < 0.001) and VDBP (351.2 (252.2–530.6) vs. 330.8 (183.5–560.3) mg/dL, p < 0.05) than patients without active inflammation. Serum 24,25OH2D levels were negatively correlated with erythrocyte sedimentation rate (ESR) (−0.155, p = 0.049) while concentrations of serum 1,25OH2D correlated positively with hsCRP (0.157, p = 0.036). Correlations with serum VDBP levels were found for ESR (0.150, p = 0.049), transferrin (0.160, p = 0.037) and hsCRP (0.261, p < 0.001). Levels of serum free and bioavailable 25OHD showed a negative correlation with ESR (−0.165, p = 0.031, −0.205, p < 0.001, respectively) and hsCRP (−0.164, p = 0.032, −0.208, p < 0.001 respectively), and a moderate negative correlation with fecal calprotectin (−0.377, p = 0.028, −0.409, p < 0.016, respectively). Serum total 25OHD concentration was the only vitamin D parameter found to have no specific correlation with any of the inflammatory markers. According to these results, the traditional parameter, total 25OHD, still appears to be the best marker of vitamin D status in patients with inflammatory bowel disease regardless of the presence of inflammation.

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“…Bis zu 60% der IBD-Patienten, insbesondere Patienten mit der Diagnose MC und erhöhter Krankheitsaktivität [72, 193, 194] sowie Schwangere mit IBD, leiden an Vitamin-D-Mangel [195]. Interessanterweise besitzen junge männliche Patienten ein sehr hohes Risiko [141], und MC-Patienten mit isolierter Kolonbeteiligung bzw.…”

Section: Fehlernährungunclassified

Ernährung bei entzündlichen Darmerkrankungen

Schreiner

Martinho-Grueber

Studerus³

et al. 2020

Kompass Autoimmun

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Ernährung • Morbus Crohn • Colitis ulcerosa Zusammenfassung Hintergrund: Die Übernahme einer westlichen Lebensweise, insbesondere der damit verbundenen ernährungsbezogenen Veränderungen, gilt als einer der wichtigsten Faktoren, der zur steigenden Inzidenz entzündlicher Darmerkrankungen (IBD, inflammatory bowel disease), hauptsächlich Morbus Crohn und Colitis ulcerosa, beiträgt. Zusammenfassung: Die Ernährung stellt für Patienten mit IBD ein zentrales und intuitiv relevantes Thema dar. Auch wenn eine beträchtliche Zahl von Patienten geneigt ist, Ernährungsempfehlungen verschiedenster Anbieter, u.a. aus der Laienpresse, zu befolgen, lassen sich solche Anregungen nur selten durch wissenschaftliche Evidenzdaten untermauern. Dies kann dazu führen, dass Ärzte über verschiedene Aspekte der Ernährung unzureichend informiert sind, was wiederum eine fachgerechte Beratung ihrer Patienten mit IBD von vorne herein ausschließt. Zudem sind Patienten mit IBD gefährdet, Eisen-, Vitamin-B12-, und Folsäuremangel sowie einen Mangel an verschiedenen Mikronährstoffen zu entwickeln, der bei Patienten mit aktiver Erkrankung und solchen, die eine strikte Diät befolgen, besonders stark ausgeprägt sein kann. Ziel der

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Vitamin D deficiency in a European inflammatory bowel disease inception cohort: an Epi-IBD study

Abstract: This study demonstrates the high prevalence of low vitamin D levels in treatment-naive European IBD populations. Furthermore, it demonstrates the presence of low vitamin D levels in patients with IBD who smoke.

Cited by 29 publications

References 45 publications

High Prevalence of Untreated and Undertreated Vitamin D Deficiency and Insufficiency in Patients with Inflammatory Bowel Disease

High Prevalence of Untreated and Undertreated Vitamin D Deficiency and Insufficiency in Patients with Inflammatory Bowel Disease

Measuring Vitamin D Status in Chronic Inflammatory Disorders: How does Chronic Inflammation Affect the Reliability of Vitamin D Metabolites in Patients with IBD?

Ernährung bei entzündlichen Darmerkrankungen

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