Association of Vitamin D level with clinical status in inflammatory bowel disease: A 5-year longitudinal study

Toufic A. Kabbani, Ioannis E. Koutroubakis, Robert E. Schoen, Claudia Ramos-Rivers, Nilesh Shah, Jason Swoger, Miguel Regueiro, Arthur Barrie, Marc Schwartz, Jana G. Hashash, Leonard Baidoo, Michael A. Dunn, David G. Binion*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

124 Scopus citations

Abstract

OBJECTIVES:Emerging data suggest that vitamin D has a significant role in inflammatory bowel disease (IBD). Prospective data evaluating the association of vitamin D serum status and disease course are lacking. We sought to determine the relationship between vitamin D status and clinical course of IBD over a multiyear time period.METHODS:IBD patients with up to 5-year follow-up from a longitudinal IBD natural history registry were included. Patients were categorized according to their mean serum 25-OH vitamin D level. IBD clinical status was approximated with patterns of medication use, health-care utilization, biochemical markers of inflammation (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)), pain and clinical disease activity scores, and health-related quality of life.RESULTS:A total of 965 IBD patients (61.9% Crohn's disease, 38.1% ulcerative colitis) formed the study population (mean age 44 years, 52.3% female). Among them, 29.9% had low mean vitamin D levels. Over the 5-year study period, subjects with low mean vitamin D required significantly more steroids, biologics, narcotics, computed tomography scans, emergency department visits, hospital admissions, and surgery compared with subjects with normal mean vitamin D levels (P<0.05). Moreover, subjects with low vitamin D levels had worse pain, disease activity scores, and quality of life (P<0.05). Finally, subjects who received vitamin D supplements had a significant reduction in their health-care utilization.CONCLUSIONS:Low vitamin D levels are common in IBD patients and are associated with higher morbidity and disease severity, signifying the potential importance of vitamin D monitoring and treatment.

Original languageEnglish (US)
Pages (from-to)712-719
Number of pages8
JournalAmerican Journal of Gastroenterology
Volume111
Issue number5
DOIs
StatePublished - May 1 2016

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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