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P258. Do we really have to measure vitamin D in inflammatory bowel disease patients?

O. Sentürk1, G. Sirin1, A. Celebi1, H. Ylmaz1, G. Dindar1, S. Hulagu1, 1Kocaeli University, Gastroenterology, Kocaeli, Turkey

Background

There is increasing interest in the role of vitamin D in inflammatory bowel disease, outside of its traditional role in metabolic bone disease. Recent data suggest an association between vitamin D deficiency and disease activity in IBD. We aimed in this study to determine the prevalence of vitamin D deficiency in IBD patients and the association with disease phenotype and severity. On the other hand we want to investigate whether we are measuring vitamin D levels at any encounter in out IBD patients.

Methods

This study was conducted in Kocaeli University Medical Faculty Hospital. Information was gathered using the hospital powerchart system and the IBD database of gastroenterology departments patients.

Patients were recruited from outpatient polyclinic consecutively and evaluated retrospectively. Clinical data including demographics, disease phenotype by the Montreal classification, level of deficiency and season tested were recorded from clinical and electronic records. Data regarding IBD-related surgery and medication prescribed was also collected. Vitamin D (25OHD) levels were classified as insufficient (20–40 ng/mL), deficient (10–20 ng/mL) or severe deficiency (<10 ng/mL).

Results

A total of 326 patients were correctly identified as having IBD. Of these, 210 (64.4%) had Ulcerative colitis (UC) and 116 (35.6%) had Crohn's disease (CD). 130 (36.9%) had a 25OHD level measured subsequent to diagnosis. Of these 69.2% were female and median age at diagnosis was 38 (84 CD and 46 UC). There was no significant difference in the median 25OHD level between CD and UC (34, IQR 21–51 vs 27, IQR 16–48, p = 0.4). 20%, 23.1%, 36.9% and 20% had normal, insufficient, deficient and severe deficiency respectively. In those with severe deficiency 38.5% were tested during winter. 78 of 130 (80%) patients had low 25OHD levels. 38 patients of these were also followed by the Rheumatology team for co-existing arthropathy or arthritis.

There were significant differences in disease outcomes in those with severe deficiency compared to normal levels with regard to need for surgery in CD (41.2% vs 17.6%), penetrating disease phenotype in CD (47.1% vs 11.8%), need for oral steroids within 3 months of diagnosis (52.9% vs 23.5%) and diagnosis of pancolitis at presentation in UC patients (23.5% vs 5.9%).

Conclusion

This study demonstrates that vitamin D deficiency is common in IBD and may be associated with markers of severe disease. We suggest monitoring of vitamin D levels and correction with eligible supplements in patients with IBD.