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Vitamin D Deficiency Common in Active IBD, Increased with Symptom Severity
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Vitamin D deficiency is common in patients with inflammatory bowel disease and in those with greater severity of symptoms, and although supplementation improved vitamin D levels in some, few patients were adherent, according to study researchers.
The study was initially composed of 137 patients (95 with Crohn’s disease, 42 with ulcerative colitis; mean age, 32.2 years), but only 131 patients had contemporaneous vitamin D levels required to participate. Patients were aged 18 to 50 years and were observed for 12 months between 2012 and 2014. Vitamin D levels were measured, and disease activity was assessed using the partial Mayo score/Crohn’s Disease Activity Index when appropriate, C-reactive protein and fecal calprotectin; quality of life using the IBD questionnaire; and bone mineral density with a dual energy X-ray absorptiometry scan.
Thirty-nine participants were deficient in vitamin D (30%) when the study began, and 38% of patients had either osteopenia (n=49) or osteoporosis (n=3); 45% of those participants were deficient in vitamin D vs. 29% of those with normal vitamin D levels.
At 12-month follow-up (n=80 patients), 29% of patients had low vitamin D, 58% of whom were deficient at baseline. Only 10 of 30 patients who were advised to supplement with vitamin D reported adherence. Eight of 10 of those achieved sufficient vitamin D levels, whereas 13 of 20 patients remained deficient and seven developed sufficient levels without supplementation. None had significant changes in IBD questionnaire scores.
“Despite advice, vitamin D therapy was poorly adopted, but biochemically successful when taken,” the researchers wrote. “As yet, the relationships among disease activity, quality of life and vitamin D and the role of supplementation are unclear; however, for prevention of future osteoporosis alone, it may be justified given the prevalence of deficiency we have discovered.”
Disclosure: The researchers reported no relevant financial disclosures.
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