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P608 Hypovitaminosis D correlates with a more severe disease course in Inflammatory Bowel Disease patients

G. Tapete, V. Almerigogna, F. Bucciero, A. Cozzi, M. Giannotta*, G. Macrì, S. Milani, M. Milla

AOU Careggi, Regional Referral Center fo Inflammatory Bowel Disease - Gastroenterology 1 Division, Florence, Italy

Background

Increasing evidences suggests an implication of hypovitaminosis D in immuno-mediated disease, including Inflammatory Bowel Disease (IBD). Moreover, some authors reported a correlation between hypovitaminosis D, disease history and clinical features in Crohn's Disease (CD) and Ulcerative Colitis (UC). The aim of this study is to evaluate vitamin D serum levels in a IBD patients population and to correlate the prevalence of hypovitaminosis D with disease history and clinical features

Methods

Patients from our center affected by UC or CD were enrolled from october 2013 to november 2014. Exclusion criteria were age below 18 and over 60, concomitant vitamin D replacement therapy and concomitant gastrointestinal or endocrinological diseases which may alter vitamin D metabolism. Enrolled patients underwent 25-OH-vitaminD and C-reactive protein (PCR) plasmatic assay. According to 2012 Osteoporosis Italian Society Guidelines, we defined as hypovitaminosis D plasmatic values below 30 ng/mL, vitamin D levels were considered as insufficient if between 20 and 30 ng/mL and deficient if < 20 ng/mL. We collected data regarding patients life habits and clinical history, disease course and disease clinical activity at enrollment

Results

We enrolled 88 patients (62 CD, 26 UC), median age at enrollment was 42 years for CD and 43 years for UC. Mean Body Mass Index (BMI) was 22.6 in CD and 23.7 in UC patients. Age at diagnosis was 29.8 years for CD and 33.5 years for UC, with mean disease duration of 12.8 years for CD and 9.1 years for UC. Hypovitaminosis D was observed in 84.1% of cases with insufficient and deficient vitamin D levels in 31.8% and 57.3% of patients respectively. Mean vitamin D level was 20.4 ng/mL and no difference has been found according to patients' sex or disease type. In our study hypovitaminosis D did not correlate with disease duration nor patients' age at diagnosis. A statistically significant correlation has been found between hypovitaminosis D and history of steroid-dependancy (p = 0.03), need of biological therapy (p = 0.01) and cigarette smoke habit in CD patients (p = 0.01). Furthemore, in CD patients we found a correlation, at the limit of statistical significance, between hypovitaminosis D, altered PCR values and Harvey-Bradshaw Index (HBI) at enrollment (p=0.05)

Conclusion

In our study we found a high prevalence of hypovitaminosis D in a young IBD population regardless of patients' sex, disease type and duration. Our data showed a strong correlation between hypovitaminosis D and a more aggressive disease course in terms of history of steroid-dependancy, need of biological therapy and smoke habit in CD patients. Hypovitaminosis D may be crucial in determining a more severe clinical behavior of IBD