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P169. Prevalence of vitamin D deficiency in IBD patients and its correlation with disease activity

A. Krajcovicova1, J. Toth1, T. Koller1, Z. Zelinkova1, S. Oravcova1, M. Huorka1, T. Hlavaty1, 1University Hospital Bratislava, Bratislava, Slovakia

Background

Inflammatory bowel diseases (IBD) are chronic relapsing immune mediated diseases with unclear aetiology. Vitamin D is a fat soluble secosterol produced in the skin after the sun exposure with potent immunomodulatory activities. The high prevalence of IBD in North America and Europe, genetic analyses and animal studies implicate vitamin D status as a possible environmental factor that contributes to IBD development. The aim of this study was to determine the vitamin D status in a group of IBD patients and to analyse the correlation of vitamin D and disease activity.

Methods

The cohort consisted of 68 patients with Crohn's disease (CD) and 38 patients with ulcerative colitis (UC) followed up in the IBD centre of University hospital Bratislava-Ruzinov between January 1st and September 30th 2010. In every patient clinical characteristic were determined. Further we measured the level of serum 25(OH)-vitamin D, CRP, ERS and semi quantitative stool calprotectin level. Quality of life was assessed by means of the short IBD quality of life questionnaire (sIBDQ). Prevalence of 25(OH)-vitamin D deficiency (<30 ng/ml), severe 25(OH)-vitamin D deficiency (<10 ng/ml) and its association with disease activity parameters (ESR, CRP, calprotectin, sIBDQ) was analysed.

Results

25(OH)-vitamin D deficiency was noted in 103/106 (97.2%), severe 25(OH)-vitamin D deficiency in 22/106 (20.7%) of IBD patients. There was a higher prevalence of severe 25(OH)-vitamin D deficiency in patients with CD (17/68, 25%) as compared to UC (5/35, 14.2%), p = 0.03. There was a significant difference in CRP levels (15.0±21.1 vs. 7.6±15.9 mg/L, p = 0.03) and sIBDQ (52.3±12.1 vs. 58.3±8.3, p = 0.03) between severe 25(OH)-vitamin D deficient and non-severely deficient Crohn's disease patients. There was a significant negative correlation between CRP and 25(OH)-vitamin D level in patients with Crohn's disease (r = −0.2, p < 0.05). No similar association was seen in UC patients.

Conclusion

The results of the realised study indicate a high prevalence of vitamin D deficiency and also the strong influence of vitamin D on the inflammation and quality of life in patients with Crohn's disease.

Keywords: IBD, Crohn's disease, ulcerative colitis, vitamin D, calprotectin