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P231. Hypovitaminosis D in inflammatory bowel disease patients: Is there association with quality of life and disease activity?

I.A. Pintilie1, G. Dumitrescu1, M. Dranga1, E. Toader2, C. Cijevschi Prelipcean2, 1Sf. Spiridon Hospital, Gastroenterology and Hepatology, Iasi, Romania, 2University of Medicine and Pharmacy Gr. T. Popa, Gastroneterology and Hepatology, Iasi, Romania

Background

Beside the effects on calcium homeostasis and bone metabolism, vitamin D (1,25(OH)2D) was found to increase epithelial cell resistance to injury, regulate the innate response to intraluminal gut antigens and preserve mucoasal integrity. It was suggested that the prevalence of suboptimal vitamin D status may be as high as 80% among adults with inflammatory bowel disease (IBD), and that vitamin D deficiency is associated with increased disease activity and lower health-related quality of life (HRQoL).

The aim of the study was to determine the prevalence of vitamin D deficiency in IBD patients and if QoL and disease activity have any impact on vitamin D deficiency.

Methods

We performed a prospective study between January 2011 and December 2011. Crohn's disease activity index (CDAI) and ulcerative colitis disease activity index (UCDAI) were used to assess disease activity. IBDQ-32 was used to assess HRQoL. A level of 25-OH-D3 < 20 ng/ml was considered a deficit, one between 20–30 ng/ml was considered insufficient, while a level >30 ng/ml was considered adequate.

Results

The study included 180 IBD patients (46 Crohn's disease [CD] and 134 ulcerative colitis [UC]). 47.01% UC patients were vitamin D insufficient with 21.64% having severe deficienty. 43.47% CD patients were insufficient with 39.95% having vitamin D severe deficienty. 25 CD patient (67.56%) had a QoL between 50 and 120 (p < 0.05) with a CDAI score >150 in 28 patients (75.67%) with vitamin D deficiency (p < 0.05). 15 patients (16.3%) with UC and vitamin D deficiency had a QoL range from 50 to 140 (p > 0.05) and 23 patients (25%) an UCDAI score >7 (p > 0.05). Vitamin D deficiency was associated with lower QoL and increased activity index in CD but not UC.

Conclusion

Vitamin D deficiency is common in IBD and is independently associated with lower HRQoL and greater disease activity in CD. Malabsorbtion and loss throught the inflamed intestine is a possible mechanism for the higher prevalence of hypovitaminosis D in IBD patients. High prevalence of hypovitaminosis D in UC patients suggests that there are other factors that may contribute to this deficit. There is a need for prospective studies to assess this correlation and examine the impact of vitamin D supplementation on disease course.