P322. Vitamin D deficiency in Asian patients with inflammatory bowel disease
W.-C. Lim1, W.-K. Ng1, C. Vu1, 1Tan Tock Seng Hospital, Department of Gastroenterology and Hepatology, Singapore, Singapore
Vitamin D has immune-modulatory properties and is believed to be involved in the pathogenesis of inflammatory bowel disease (IBD). Vitamin D deficiency is common among patients with IBD while a higher vitamin D status significantly reduces the risk of incident Crohn's disease (CD) [1,2]. Recent data also suggests that supplemental vitamin D as an adjunctive therapy may help control colitis . However, the prevalence of vitamin D deficiency and the extent of ethnic influence remains poorly documented for Asian patients with IBD.
Case notes and electronic records of patients with IBD who has been treated at our centre were retrospectively reviewed. The performance of vitamin d levels were at the discretion of the attending physician. Vitamin D status of each patient was recorded and the data analysed using the fisher's exact and chi-square test.
Of the 90 patients with ulcerative colitis (UC) and 54 patients with CD, only 47 UC (52%) and 34 CD (63%) patients had vitamin D levels measured. Of these, 55 were Chinese, 18 Indians and 8 Malays. Of the 47 UC patients, 39 (83%) had low vitamin D levels (26 deficiency, 13 insufficiency); of the 34 CD patients, 25 (73.5%) had low vitamin D levels (18 deficiency, 7 insufficiency). There was no signficant difference in the prevalence of hypovitaminosis D among UC and CD patients (p = 0.41). Among Chinese patients with IBD, 39 (71%) had low vitamin D levels (29 deficiency, 10 insufficiency) compared to 17 (94%, 11 deficiency, 6 insufficiency) Indian and 8 (100%, 4 deficiency, 4 insufficiency) Malay IBD patients respectively (p = 0.03).
There is a high prevalence of vitamin d deficiency and insufficiency among Asian patients with IBD. While there was no difference between UC and CD patients, a significantly higher proportion of Indian and Malay IBD patients had hypovitaminosis D compared to Chinese patients. Asian patients with IBD should be screened for vitamin D deficiency/insufficiency routinely and treatment with vitamin D supplements instituted when indicated.
1. A Ulitsky, A.N. Ananthakrishnan, A Naik et al, (2011), Vitamin D Deficiency in Patients with Inflammatory Bowel Disease. Association with Disease Activty and Quality of Life, Journal of Parenteral & Enteral Nutrition, 308–316
2. Ananthakrishnan AN, Khalili H, Hiquchi LM et al, (2012), Higher predicated vitamin D status is associated with reduced risk of Crohn's disease, Gastroenterology, 482–9
3. Nicholson I, Dalzell AM, El-Matary W, (2012), Vitamin D as a therapy for colitis: a systematic review, J Crohns Colitis, 405–11