P330 Vitamin D insufficiency in patients with inflammatory bowel disease
M. d. C. Martos Plasencia*, C. Verdejo Gil, R. H. Lorente Poyatos, E. De la Santa Belda, M. Peña Gómez, R. Salmoral Luque, B. López Viedma, J. Olmedo Camacho
University Hospital of Ciudad Real, Gastroenterology and Hepatology Department, Ciudad Real, Spain
Patients with inflammatory bowel disease (IBD) have shown a higher risk of metabolic bone diseases than the general population. The chain of events involved in the development of bone tissue diseases is not perfectly known. Nutrition, drugs and inflammatory agents have been associated with the physiopathology in IBD. Vitamin D deficiency is one of the most relevant nutritional factors in terms of bone pathology. We analysed the proportion of outpatients with insufficient levels of vitamin D from the IBD unit of our tertiary hospital.
This is an observational retrospective study.The vitamin D levels were observed in ulcerative colitis and Crohn’s disease outpatients who were followed from 2012 to 2015. Insufficient vitamin D levels were defined as complete deficiency with levels below 20 ng/dl and partial deficiency from 20 to 30 ng/dl. The clinical and epidemiological features of the patients were also analysed.
Serum vitamin D levels were studied in 106 patients. Further, 48 patients (45.3%) were male, with an average age of 45.63 and an average length of disease progression of around 10.07 years. In addition, 65 patients (61.3 %) were diagnosed with Crohn’s disease, 40 patients (37.7%) with ulcerative colitis, and 1 patient (0.9 %) with indeterminate colitis. At the time of the determination, 77 patients (79.4%) were in biological remission. Serum vitamin D medium value was 20.5 ng/mL. Moreover, 59 patients (55.7%) were diagnosed with deficiency; 25 patients (23.6 %) presented partial deficiency; and 22 patients (20.8 %) had normal values. In the sub-group analysis, it appears that 53 patients (81.5%) with Crohn’s disease had suboptimal levels of vitamin D compared with 30 patients (75 %) in the ulcerative colitis group. Suboptimal levels of vitamin D were observed in 48 women (82 %) and 36 men (75 %).
According to the extent of bowel damage, 5 groups were described: insufficient vitamin D levels were shown in 6 patients (75%) in the small bowel group, 18 (90%) in the ileum group, 18 (85.71%) in the Ileocecum group, 27 (72.97%) in the descending colon, and 16 (80%) in the pancolitis group. 37 patients were being treated with anti-TNFα, 30 of them (81.08 %) had below normal vitamin D levels. The distribution of the deficiency according to gender, type of disease, need of anti-TNF alpha treatment, and extension of disease was analysed. A univariate analysis was performed, and statistical significance was not achieved in any case.
A high percentage of patients (79.3 %) with IBD whose serum vitamin D levels were tested had suboptimal levels. Supplementary treatment and bone densitometry are recommended in these patients.