Year 2019 / Volume 111 / Number 1
Original
Vitamin D deficiency in outpatients with inflammatory bowel disease: prevalence and association with clinical-biological activity

46-54

DOI: 10.17235/reed.2018.5714/2018

Raúl Vicente Olmedo Martín, Inmaculada González Molero, Gabriel Olveira Fuster, Víctor Amo Trillo, Miguel Jiménez Pérez,

Abstract
Introduction: there are few data on the prevalence of vitamin D deficiency in patients with inflammatory bowel disease (IBD) in Spain. A deficiency could be associated with a worse course of the disease. Aim: to determine the prevalence of 25-hydroxyvitamin D (25OHD) deficiency in a cohort of outpatients with IBD and assess its association with clinical and biological activity, quality of life and psychological symptoms. Methods: a cross-sectional, single-center observational study was performed. The study variables were obtained via clinical interviews, medical chart review and validated questionnaires (Hospital Anxiety and Depression Scale and Short Quality of Life in Inflammatory Bowel Disease Questionnaire). 25OHD was measured in the same laboratory by an electro-chemiluminescence immunoassay. Results: the study included 224 patients. The prevalence of vitamin D deficiency in Crohn’s disease and ulcerative colitis was 33.3% and 20.3%, respectively. In Crohn’s disease, vitamin D deficiency was associated with a higher clinical activity (p < 0.001) and a higher concentration of fecal calprotectin (p = 0.01). In ulcerative colitis, it was associated with clinical activity (p < 0.001), the use of steroids during the last six months (p = 0.001) and hospital admission during the previous year (p = 0.003). A sub-analysis of 149 patients failed to detect an association between vitamin D and quality of life or the scores of the Hospital Anxiety and Depression Scale. Conclusions: vitamin D deficiency is common in patients with inflammatory bowel disease. An association was found between vitamin D concentration and clinical activity indexes, as well as fecal calprotectin levels in Crohn’s disease.
Share Button
New comment
Comments
No comments for this article
References
1. Nielsen OH, Rejnmark L, Moss AC. Role of vitamin D in the natural history of inflammatory bowel disease. J Crohns Colitis 2018 (en imprenta)
2. White J. Vitamin D deficiency and the pathogenesis of Crohn´s disease. J Steroid Biochem Mol Biol 2018;175:23-28.
3. Mouli VP, Ananthakrishnan AN. Review article: vitamin D and inflammatory bowel diseases. Aliment Pharmacol Ther 2014;39:125-36.
4. Del Pinto R, Pietropaoli D, Chandar AK et al. Association between inflammatory bowel disease and vitamin D deficiency: a systematic review and meta-analysis. Inflamm Bowel Dis 2015; 21: 2708-17.
5. Sánchez-Cano D, Ruiz-Villaverde R, Callejas Rubio, JL et al. Vitamin D deficiency and bone mineral density in Crohn´s disease. Med Clin 2011;137:62-65.
6. Sadeghian M, Saneei P, Siassi F, et al. Vitamin D status in relation to Crohn´s disease:Meta-analysis of observational studies. Nutrition 2016;32:505-14.
7. Frigstad SO, Hoivik M, Jahnsen J et al. Vitamin D deficiency in inflammatory bowel disease:prevalence and predictors in a Norwegian outpatient population. Scand J Gastroenterol 2017; 52:100-106.
8. Raferty T, Merrick M, Healy M, et al. Vitamin D status is associated with intestinal inflammation as measured by fecal calprotectin in Crohn´s disease in clinical remission. Dig Dis Sci 2015; 60:2427-35.
9. Garg M, Rosella O, Lubel JS, et al. Association of circulating vitamin D concentrations with intestinal but not systemic inflammation in inflammatory bowel disease. Inflamm Bowel Dis 2013;19:2634-43.
10. Hlavaty T, Krajcovicoca A, Koller T, et al. Higher vitamin D serum concentrations increases health related quality of life in patients with inflammatory bowel diseases. Word J Gastroenterol 2014;20:15787-96.
11. Torki M, Gholamrezaei A, Mirbagher L, et al. Vitamin D deficiency associated with disease activity inpatients with inflmammatory bowel diseases. Dig Dis Sci 2015; 60:3085-91.
12. Mikocka-Walus A, Knowles SR, Keefer L, et al. Controversies revisited: a systematic review of the comorbidity of depression and anxiety with inflammatory bowel diseases. Inflamm Bowel Dis 2016; 22:752-62.
13. Cuomo A, Giordano N, Goracci A, et al. Depression and vitamin D deficiency: causality, assessment, and clinical implications. Neuropsychiatry 2017; 606-614.
14. Lennard-Jones JE. Classification of inflammatory bowel disease. Scand J Gastroenterol Suppl; 1989; 170: 2-6.
15. Silverberg MS, Satsangi J, Ahmad T, et al. Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroentrol 2005;19 Suppl A: 5-36A.
16. Holick MF, Binkley HA, Heike A, et al. Evaluation, treatment and prevention of vitamin D deficiency:an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab; 1911-30.
17. Colombel JF, Sandborn WJ, Rutgeerts P, et al. Adalimumab for maintenance of clinical response and remission in patients with Crohn’s
disease: the CHARM trial. Gastroenterology; 2007:132:52–65.
18. Vázquez-Morón JM, Pallarés-Manrique H, Machancoses FH et al. Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn´s disease with fecal calprotectin. Rev Esp Enferm Dig; 2017; 109:130-136.
19. Utilsky A, Ananthakrishnan AN, Naik A, et al. Vitamin D deficiency in patients with inflammatory bowel disease: association with disease activity andquality of life. J Parenter Enteral Nutr 2011;35:308-316.
20. Blanck S, Aberra F. Vitamin D deficiency is associated with ulcerative colitis disease activity. Dig Dis Sci 2013;58:1698-702.
21. Dias de Castro F, Magalhaes J, Boal Carvalho P, et al. Lower levels of vitamin D correlate with clinical disease activity and quality of life in inflammatory bowel disease. Arq Gastroenterol 2015;52: 260-265.
22. Schäffler H, Schmidt M, Huth A, et al. Clinical factors are associated with vitamin D levels in IBD patients: a retrospective analysis. J Dig Dis 2018; 19: 24-32.
23. Hassan V, Hassan S, Seyed-Javad P, et al. Association between serum 25 (oh) vitamin D concentrations and inflammatory bowel diseases (IBDs) activity. Med J Malaysia 2013; 68:34-38
24. Jorgensen SP, Hvas CL, Agnholt J, et al. Active Crohn´s disease is associated with low vitamin D levels. J Crohns Colitis 2013; e407-413.
25. Dolatshahi S, Pishgar E, Jamali R. Does serum 25 hidroxy vitamin D level predict disease activity in ulcerative colitis patients? Acta Clin Belg 2016; 71: 46-50.
26. Ham M, Longhi MS, Lahiff C, et al. Vitamin D levels in adults with Crohn´s disease are responsive to disease activity and treatment. Inflamm Bowel Dis 2014;20:856-60.
27. Schoepfer AM, Berlinger C, Strautmann A, et al. Fecal calprotectin correlates more closely with the Simple Endoscopic Score for Crohn´s disease (SES-CD) than PCR, blood leukocytes, and the CDAI. Am J Gastroenterol 2010; 105:162-9.
28. Kini GP, Young B, Herbison P, et al. Does seasonal level of serum 25-OH correlate with the activity of Croh´s disease? N Z Med J 2014;127:51-59.
29. Leichtmann GA, Bengoa JM, Bolt MJ, et al. Intestinal absorption of cholecalciferol and 25-hydroxycholecalciferol in patients with both Crohn’s disease and intestinal resection. Am J Clin Nutr 1991;51: 548-552
30. Tajika M, Matsuura A, Nakamura T, et al. Risk factors for vitamin D deficiency in patients with Crohn’s disease. J Gastroenterol 2004; 39:527-33.
31. Zullow S, Jambaulikar G, Rustgi A, et al. Risk factors for deficiency and impact repletion in a tertiary care inflammatory bowel disease population. Dig Dis Sci 2017;62:2072-78
32. Kabbani TA, Koutroubakis IE, Schoen RE, et al. Association of vitamin D level with clinical status in inflammatory bowel disease: a 5-year longitudinal study. Am J Gastroenterol 2016;111:712-9.
33. Gilman J, Shanahan F, Cashman KD. Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006;60: 889–896.
34. de Bruyn JR, van Heeckeren R, Ponsioen CY, et al. Vitamin D deficiency in Crohn’s disease and healthy controls: a prospective case-control study in the Netherlands. J Crohns Colitis 2014;8: 1267–1273.
35. Pallav K, Riche D, May WL, et al. Predictors of vitamin D deficiency in inflammatory bowel disease and health: a Mississippi perspective. World J Gastroenterol 2017; 28:638-645.
36. Suibhne TN, Cox G, Healy M, et al. Vitamin D deficiency in Crohn’s disease: prevalence, risk factors and supplement use in an outpatient setting. J Crohns Colitis 2012; 6:182–188.
37. Zator ZA, Cantu SM, Konijeti GG, et al. Pretreatment 25-hydroxivitamin D levels and durability of anti-tumour necrosis factor-alpha therapy in inflammatory bowel diseases. J Parenter Enteral Nutr 2014; 38:385-91.
38. Winter RW, Collins E, Cao B, et al. Higher 25-hydroxyvitamin D levels are associated with greater odds of remission with anti-tumour necrosis factor-alpha medications among patients with inflammatory bowel diseases. Aliment Pharmacol Ther 2017;45:653-659.
39. Malmstroem S, Rejnmark L, Imboden JB, et al. Current assays to determine free 25-hidroxyvitamin D in serum. J AOAC Int 2017; 5:1323-1327.
Related articles

Letter

Treatment with hyperbaric oxygen in a Crohn’s disease patient

DOI: 10.17235/reed.2024.10166/2023

Letter

Coincidental oral lesions in Crohn’s disease

DOI: 10.17235/reed.2023.9992/2023

Letter

Tofacitinib-induced eosinophilia

DOI: 10.17235/reed.2023.9831/2023

Letter

Duodenal stenosis surgical treatment in Crohn’s disease

DOI: 10.17235/reed.2023.9521/2023

Letter

Hepatosplenic T-cell lymphoma and inflammatory bowel disease

DOI: 10.17235/reed.2023.9472/2023

Letter

Perianal Paget’s disease

DOI: 10.17235/reed.2022.9304/2022

Letter

Chinese dragon sign of ulcerative colitis

DOI: 10.17235/reed.2022.9154/2022

Letter

Ulcerative colitis exacerbated by strongyloidiasis

DOI: 10.17235/reed.2022.9044/2022

Digestive Diseases Image

Peristomal cutaneous Crohn's disease by contiguity

DOI: 10.17235/reed.2022.8909/2022

Review

Clinical settings with tofacitinib in ulcerative colitis

DOI: 10.17235/reed.2022.8660/2022

Letter

Mesalazine induced interstitial pneumonitis in the COVID era

DOI: 10.17235/reed.2022.8635/2021

Letter

Anal neoplasia and perianal Crohn’s disease: myth or reality?

DOI: 10.17235/reed.2021.8317/2021

Letter

Apoptotic colopathy as a manifestation of Good’s syndrome

DOI: 10.17235/reed.2021.8297/2021

Original

Radon exposure and inflammatory bowel disease in a radon prone area

DOI: 10.17235/reed.2021.8239/2021

Review

Inflammatory bowel disease and solid organ transplantation

DOI: 10.17235/reed.2020.7361/2020

Letter

The effect of Adacolumn® on ulcerative colitis with COVID-19

DOI: 10.17235/reed.2020.7156/2020

Letter

Sweet syndrome in severe ulcerative flare

DOI: 10.17235/reed.2020.6995/2020

Editorial

Is celiac disease really associated with inflammatory bowel disease?

DOI: 10.17235/reed.2019.6779/2019

Letter

Crohn’s disease in patients treated with etanercept

DOI: 10.17235/reed.2019.6554/2019

Original

Megacolon in inflammatory bowel disease: response to infliximab

DOI: 10.17235/reed.2020.6394/2019

Editorial

Diet in the etiology of inflammatory bowel disease

DOI: 10.17235/reed.2018.6119/2018

Case Report

Serrated Lesions in patients with Inflammatory Bowel Disease.

DOI: 10.17235/reed.2019.5910/2018

Editorial

Online social networks and inflammatory bowel disease

DOI: 10.17235/reed.2018.5496/2018

Letter to the Editor

Idiopathic portal hypertension with regard to thiopurine treatment

DOI: 10.17235/reed.2018.5256/2017

Letter to the Editor

Ulcerative colitis with gastric and duodenal involvement

DOI: 10.17235/reed.2017.4685/2016

Editorial

Specialist care in the management of inflammatory bowel disease

DOI: 10.17235/reed.2016.4628/2016

Original

Mercaptopurine and inflammatory bowel disease: the other thiopurine

DOI: 10.17235/reed.2016.4546/2016

Letter to the Editor

Adnexal localization of Crohn’s disease and recurrent massive ovary cysts

DOI: 10.17235/reed.2016.4301/2016

Case Report

Mesalamine-induced myopericarditis - A case report

DOI: 10.17235/reed.2016.4016/2015

Case Report

Metastatic Crohn’s disease in pediatrics

DOI: 10.17235/reed.2016.3948/2015

Letter to the Editor

Crohn’s disease and Sweet’s syndrome: A debut together

DOI: 10.17235/reed.2015.3842/2015

Case Report

Ovarian involvement in Crohn´s disease: A rare complication

DOI: 10.17235/reed.2015.3764/2015

Citation tools
Olmedo Martín R, González Molero I, Olveira Fuster G, Amo Trillo V, Jiménez Pérez M. Vitamin D deficiency in outpatients with inflammatory bowel disease: prevalence and association with clinical-biological activity. 5714/2018


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1806 visits.
This article has been downloaded 478 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 09/05/2018

Accepted: 10/07/2018

Online First: 04/10/2018

Published: 17/01/2019

Article revision time: 57 days

Article Online First time: 148 days

Article editing time: 253 days


Share
This article has been rated by 2 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology