Risk Factors for Vitamin D Deficiency and Impact of Repletion in a Tertiary Care Inflammatory Bowel Disease Population

Dig Dis Sci. 2017 Aug;62(8):2072-2078. doi: 10.1007/s10620-017-4614-y. Epub 2017 May 25.

Abstract

Introduction: Many patients with inflammatory bowel disease (IBD) are vitamin D deficient. The purpose of our study was to identify risk factors for vitamin D deficiency in IBD and to assess the impact of vitamin D repletion on disease activity and quality of life (QOL).

Methods: Patients with at least one 25-OH vitamin D level measured between 2004 and 2011 were included. Patients with a level <30 ng/ml at baseline were followed until the time of repletion. QOL and disease activity scores were measured at baseline and repletion.

Results: A total of 255 patients were identified. 33, 29, and 39% had a vitamin D level of ≥30, 20-29, and <20 ng/ml, respectively. When adjusting for disease type and duration, gender, smoking, and race, non-Caucasians had 5.3 (2.3-12.3) and UC patients had a 0.59 (0.33-1.03) odds of having a vitamin D <30 ng/ml. Women were 1.7 times more likely to have a 25-OH vitamin D level <20 ng/ml than men. 55 patients underwent repletion. In CD patients, the HBI and SIBDQ prior to repletion was 5.5 ± 4.9 and 44.3 ± 16.4, respectively; these improved to 3.6 ± 3.4 and 48.6 ± 14.2 after repletion (p = 0.0154 and p = 0.0684).

Conclusions: In this tertiary care IBD cohort, the majority of patients have low vitamin D levels. Non-Caucasian race and female gender are associated with low vitamin D. UC was associated with lower risk of vitamin D insufficiency. In CD, vitamin D repletion is associated with decreased disease activity and increased QOL.

Keywords: Disease activity; Inflammatory Bowel Disease; Vitamin D.

MeSH terms

  • Adult
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / complications*
  • Crohn Disease / blood
  • Crohn Disease / complications*
  • Dietary Supplements*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality of Life
  • Racial Groups
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Tertiary Healthcare
  • Treatment Outcome
  • Vitamin D / administration & dosage*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / drug therapy
  • Vitamin D Deficiency / etiology*
  • Vitamins / administration & dosage*

Substances

  • Vitamins
  • Vitamin D
  • 25-hydroxyvitamin D