Vitamin D Deficiency is Associated with Increased Disease Activity in Patients with Inflammatory Bowel Disease

• Main Authors: Johannes Hausmann, Alica Kubesch, Mana Amiri, Natalie Filmann, Irina Blumenstein
• Format: Article
• Language: English
• Published: MDPI AG 2019-08-01
• Series: Journal of Clinical Medicine
• Subjects: IBD; Crohn’s disease; Ulcerative colitis; intestinal barrier; mucosal inflammation; vitamin D; calcitriol
• Online Access: https://www.mdpi.com/2077-0383/8/9/1319

Background and Aims: Vitamin D has an inhibitory role in the inflammatory signaling pathways and supports the integrity of the intestinal barrier. Due to its immunomodulatory effect, vitamin D plays a role in chronic inflammatory bowel disease (IBD) and a deficiency is associated with an increased risk for a flare. We aimed to investigate to what extent the 25-hydroxyvitamin D (25(OH)D₃) level correlates with disease activity and whether a cut-off value can be defined that discriminates between active disease and remission. Methods: Patients with IBD, treated at the University Hospital Frankfurt were analyzed retrospectively. The 25(OH)D3 levels were correlated with clinical activity indices and laboratory chemical activity parameters. A deficiency was defined as 25(OH)D3 levels &lt;30 ng/mL. Results: A total of 470 (257 female) patients with IBD were included, 272 (57.9%) with Crohn&#8217;s disease (CD), 198 (42.1%) with ulcerative colitis (UC). The median age of the patients was 41 (18&#8722;84). In 283 patients (60.2%), a vitamin D deficiency was detected. 245 (53.6%) patients received oral vitamin D supplementation, and supplemented patients had significantly higher vitamin D levels (<i>p</i> &lt; 0.0001). Remission, vitamin D substitution, and male gender were independently associated with the 25(OH)D3 serum concentration in our cohort in regression analysis. A 25(OH)D3 serum concentration of 27.5 ng/mL was the optimal cut-off value. Conclusion: Vitamin D deficiency is common in IBD patients and appears to be associated with increased disease activity. In our study, vitamin D levels were inversely associated with disease activity. Thus, close monitoring should be established, and optimized supplementation should take place.