Clinical factors are associated with vitamin D levels in IBD patients: A retrospective analysis

J Dig Dis. 2018 Jan;19(1):24-32. doi: 10.1111/1751-2980.12565.

Abstract

Objective: There is growing evidence that vitamin D deficiency plays a role in the development and the course of inflammatory bowel disease (IBD). However, the correlation between vitamin D deficiency and clinical parameters in IBD is still not completely understood.

Methods: A retrospective study of IBD patients was performed. Vitamin D values were analyzed, regardless of vitamin D substitution administration, and correlated with clinical parameters such as medical therapy, anatomical situation, location of the disease and disease activity. Level of 25-hydroxyvitamin D [25(OH)D] <50 nmoL/L was regarded as vitamin D deficiency and <75 nmoL/L as insufficiency.

Results: In total, 208 IBD patients were analyzed, including 123 with Crohn's disease (CD) and 85 with ulcerative colitis (UC). Therapy with azathioprine did not affect the vitamin D values of either disease entity. But CD patients benefited from therapy with tumor necrosis factor-α inhibitor and exhibited significantly higher vitamin D levels than those without. Furthermore, significantly lower vitamin D levels were found if CD was located in the small bowel or if the small bowel had been resected. Moreover, significantly lower levels of vitamin D were detectable for high disease activity (reflected by high simple clinical colitis activity index values) in patients with UC.

Conclusions: Vitamin D deficiency is common in patients with IBD. However, certain clinical situations lead to significantly lower vitamin D levels and may therefore require close monitoring for vitamin D deficiency.

Keywords: Crohn disease; inflammatory bowel diseases; tumor necrosis factor-alpha; ulcerative colitis; vitamin D.

MeSH terms

  • Azathioprine / therapeutic use
  • Cholecalciferol / therapeutic use
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / pathology
  • Colitis, Ulcerative / therapy
  • Crohn Disease / blood
  • Crohn Disease / complications
  • Crohn Disease / pathology
  • Crohn Disease / therapy
  • Gastrointestinal Agents / therapeutic use
  • Germany / epidemiology
  • Humans
  • Inflammatory Bowel Diseases / blood
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / pathology
  • Inflammatory Bowel Diseases / therapy
  • Postoperative Period
  • Retrospective Studies
  • Seasons
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / drug therapy

Substances

  • Gastrointestinal Agents
  • Tumor Necrosis Factor-alpha
  • Vitamin D
  • Cholecalciferol
  • 25-hydroxyvitamin D
  • Azathioprine