Vitamin D Levels as a Potential Modifier of Eosinophilic Esophagitis Severity in Adults

Abstract

Background: Vitamin D deficiency is associated with atopic and immune-mediated diseases but has not been extensively assessed in eosinophilic esophagitis (EoE). We aimed to assess if vitamin D levels in newly diagnosed EoE patients were lower than in non-EoE controls and examine levels in relation to EoE clinical features.

Methods: This secondary analysis of a prospective cohort study used data and biosamples from adults who underwent outpatient esophagogastroduodenoscopy. Before each procedure, blood was obtained and stored at -80^oC. Serum 25-hydroxy-vitamin D₃ (25(OH)D₃) was measured by ELISA. Levels for cases and controls were compared at baseline. Within cases, 25(OH)D₃ levels were compared for clinical, endoscopic, and histologic measures.

Results: We analyzed 40 EoE and 40 non-EoE controls. Mean serum 25(OH)D₃ level was slightly lower in EoE patients than controls (30.9 ± 15.3 ng/mL vs. 35.9 ± 15.4; p = 0.15). After controlling for age, sex, and race, adjusted levels were 10.8 ng/mL lower in EoE patients (95% CI: -19.0, -2.5), but 25(OH)D₃ deficiency (< 20ng/mL) was similar in cases and controls (20% vs. 15%; p = 0.56). Levels of 25(OH)D₃ were not associated with differences in clinical or endoscopic features of EoE, and EREFS and eosinophil counts did not significantly correlate with 25(OH)D₃ levels (R of -0.28 [p = 0.08] and - 0.01 [p = 0.93], respectively). 25(OH)D₃ levels were lower in EoE cases with lamina propria fibrosis (23.2 ± 9.6 vs. 45.0 ± 17.7; p = 0.03).

Conclusions: After adjusting for age, sex, and race, 25(OH)D₃ levels were lower in EoE cases than controls, but deficiency was not common. 25(OH)D₃ levels were generally similar across most EoE disease features.

Keywords: Endoscopy; Eosinophils; Esophagitis; Vitamin D; Vitamin D Deficiency.