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P787 Vitamin D status and clinical outcomes in inflammatory bowel disease patients: a systematic review and meta-analysis

J. M. Gubatan*1,2, N. D. Chou1, O. H. Nielsen3, A. C. Moss1

1Beth Israel Deaconess Medical Center, Harvard Medical School, Division of Gastroenterology and Hepatology, Boston, USA, 2Stanford University School of Medicine, Division of Gastroenterology and Hepatology, Stanford, USA, 3Herlev Hospital, University of Copenhagen, Department of Gastroenterology, Copenhagen, Denmark

Background

Vitamin D has been implicated to play a role in the pathogenesis of inflammatory bowel disease (IBD). Vitamin D deficiency occurs in up to 30–40% of patients with IBD, yet its association with IBD clinical outcomes is conflicting. We performed a systematic review and meta-analysis examine the impact of low vitamin D status on clinical outcomes in patients with IBD.

Methods

We searched Medline, Embase, Scopus, and Web of Science from inception to February 2018 for observational studies evaluating the impact of low 25(OH)D status on IBD clinical outcomes (disease activity, mucosal inflammation, clinical relapse, and quality of life). Odds ratios (ORs) were pooled and analysed using a random effects model.

Results

Twenty-seven observational studies comprising 8316 IBD patients (3115 ulcerative colitis, 5201 Crohn’s disease) were included in our analysis. Quality of included studies per the Newcastle-Ottawa scale was high. Low vitamin D status was associated with increased odds of clinically active disease (pooled OR 1.53, 95% CI 1.32–1.77, p < 0.00001, I2 = 0%), mucosal inflammation (pooled OR 1.25, 95% CI 1.06–1.47, p = 0.008, I2 = 0%), low quality-of-life scores (pooled OR 1.30, 95% CI 1.06–1.60, p = 0.01, I2 = 0%), and clinical relapse (pooled OR 1.31, 95% CI 1.17–1.47, p < 0.00001, I2 = 0%).

Conclusion

Low serum vitamin D status among IBD patients is associated with adverse clinical outcomes. Interventional studies are needed to determine whether aiming for higher 25(OH)D concentrations may decrease the risk of poor outcomes associated with a low vitamin D status.