Factors affecting vitamin D deficiency in active inflammatory bowel diseases

Burrelli Scotti G1, Afferri MT2, De Carolis A2, Vaiarello V2, Fassino V3, Ferrone F3, Minisola S3, Nieddu L4, Vernia P2. Dig Liver Dis. 2018 Dec 7. pii: S1590-8658(18)31275-1. doi: 10.1016/j.dld.2018.11.036. [Epub ahead of print]

Author information

1 Department of Internal Medicine and Medical Specialties, Gastroenterology, Sapienza University of Rome, Rome, Italy. Electronic address: giorgiabs90@libero.it.

2 Department of Internal Medicine and Medical Specialties, Gastroenterology, Sapienza University of Rome, Rome, Italy.

3 Department of Internal Medicine and Medical Specialties, Internal Medicine A and Metabolic Bone Diseases, Sapienza University of Rome, Rome, Italy.

4 Faculty of Economics, UNINT University of International Studies, Rome, Italy.


BACKGROUND: Hypovitaminosis D is prevalent in inflammatory bowel disease (IBD) and may be associated with disease activity.

AIM: This study evaluated vitamin D (VitD) status in an Italian cohort of IBD patients, not taking VitD supplementation. We investigated risk factors for VitD deficiency and its correlation with disease activity.

METHODS: VitD levels were measured in 300 consecutive outpatients (42% with Crohn's Disease (CD) and 58% with ulcerative colitis (UC), 56% male) from a tertiary referral center. Data from the IBD cohort were compared with those of 234 healthy controls, matched by sex, age, and the month in which VitD levels were measured.

RESULTS: The mean VitD level in IBD patients was significantly lower than in controls (18.9 ng/ml vs. 25 ng/ml, p < 0.001) when accounting for gender, age, and season. VitD deficiency was present in 62% of IBD patients. Risk factors for deficiency were: age <40 and ≥60 years, winter, previous surgery, C-reactive protein (CRP) ≥0.5 mg/dl, and erythrocyte sedimentation rate ≥20 mm/h. In multivariate analysis, VitD levels were negatively influenced by disease location and CRP in UC.

CONCLUSIONS: Although VitD deficiency was more prevalent than expected in healthy controls living in a Mediterranean country not at high risk of hypovitaminosis D, it was more common and severe in IBD patients. This study also found an association between VitD status and disease activity.

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