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P298. Vitamin D status and inflammatory bowel disease - the role in disease activity and quality of life

F. Dias de Castro1, J. Magalhães1, P. Boal Carvalho1, M.J. Moreira1, P. Mota2, J. Cotter1, 1Centro Hospitalar do Alto Ave, Gastroenterology, Guimaraes, Portugal, 2Centro Hospitalar do Alto Ave, Clinical Pathology, Guimarães, Portugal

Background

Inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), is a group of debilitating conditions associated with deregulated mucosal immune response to intestinal microorganisms in a genetically susceptible host. Vitamin D is well recognized for its involvement in calcium homeostasis and musculoskeletal health. In addition, vitamin D plays a role in a variety of other systems and pathologies such as the immune response.

The aim of this study is to investigate the correlation between disease activity and quality of life, in a cohort of IBD patients, with serum vitamin D levels.

Methods

We conducted a cross-sectional study in ambulatory care IBD patients. Clinical disease activity (Harvey–Bradshaw and Mayo clinical score) and quality of life (Short Inflammatory Bowel Disease Questionnaire - SIBDQ) were assessed through validated questionnaires. Serum 25-hydroxy-vitamin D levels were used for vitamin D status, and deficiency was defined as a level less than 30 ng/mL. C-reactive protein (CRP), ferritin, albumin, erythrocyte sedimentation rate (ESR) and hemoglobin levels were correlated with serum 25-hydroxy-vitamin D levels. All samples were collected during summer months.

Statistical analysis was performed with SPSS vs 18.0 and a p value of less than 0.05 was considered statistically significant.

Results

A total of 76 patients were enrolled, 72.4% female with mean age 34±10 years, 19 with UC (25%) and 57 with CD (75%). Average serum 25-hydroxy-vitamin D levels were low (all 26±10 ng/mL, UC 30±12.54 ng/mL, CD 24.6±8.04 ng/mL) and there was a statistically significant difference between UC and CD patients (p = 0.032). Hypovitaminosis D was found in 68% of all patients, 58% of UC and 72% of CD patients. A significantly higher proportion of patients with low levels of vitamin D had higher levels of CRP (10.7 vs 4.3 mg/L, p = 0.048). On the other hand, the presence of anemia, low levels of albumin, and higher levels of ferritin and ESR didn't correlate significantly with lower levels of vitamin D. Mean Harvey–Bradshaw was 2.74 (0–15), mean Mayo clinical score was 1.95 (0–8), mean SIBDQ was 51 for UC patients and 50 for CD patients. Vitamin D deficiency didn't correlate with clinical IBD activity (CD p = 0.278; UC p = 0.224) or lower levels of quality of life (p = 0.993).

Conclusion

A significantly high percentage of IBD patients had vitamin D deficiency, and this condition was significantly more frequent in CD patients, drawing attention to the need for supplementation. CRP levels trended towards an inverse relationship with vitamin D status. In our study clinical disease activity and quality of life didn't correlate significantly with lower levels of vitamin D.