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P814 Vitamin D levels and correlations in inflammatory bowel diseases

P. Kourkoulis*1, C. Kapizioni1, G. Koutoufaris1, P. Giannelis1, A. Mellos1, K. Milioni1, K. Makris1, E. Xourgia1, V. Ntouli1, G. Michalopoulos1, S. Vrakas1, V. Xourgias1

1Tzaneion General Hospital of Piraeus, Department of Gastroenterology, Piraeus, Greece

Background

Vitamin D (vitD) deficiency occurs more commonly in the inflammatory bowel disease (IBD) than in general population and it has been associated with IBD pathogenesis, disease activity, severity and outcome. VitD also exerts immunomodulatory actions that could be beneficial for IBD. The aim of our study was to determine the prevalence of vitD deficiency among IBD patients and assess for correlations with disease and patients’ characteristics, drug treatment, steroid exposure and bone density status.

Methods

Patients that have recently undergone colonoscopy were included in the study and their serum 25-hydroxy vitD levels were measured. The patients’ endoscopic activity was recorded as no- or mucosal healing, which was defined as Mayo sub-score=0, SES-CD score=0 or Rutgeerts score=0 for Ulcerative colitis (UC), Crohn’s disease (CD) and CD patients with ileocolonic resection, respectively. The patients’ age, disease type and duration, location, previous surgery, current medical treatment, steroid exposure and bone density status were also recorded. Statistical analysis (linear regression analysis) of the data was then performed to assess for statistically significant differences.

Results

In total, 68 patients (66.2% with CD and the rest with UC), with a mean age of 45.9 years old, were enrolled in the study. 24.4% of CD patients had ileal disease, 6.6% had colitis, 50% had ileocolitis while 14.6% had undergone surgery. 30.4% of UC patients had left-sided, 69.5% had extensive disease while none had proctitis. 51.5% had mucosal healing on endoscopy with the rest exhibiting a degree of endoscopic abnormality. The patients’ current medical treatment, prior exposure to steroids and bone density status were as follows:

Only 8 patients had normal vitD levels (>30 ng/ml) while 32% had insufficient (20–30 ng/ml) and 55.9% had deficient ( < 20 ng/ml) levels. The overall mean vitD level was 21.24 ng/ml. On multivariable analysis, none of the studied variables was found to be independently associated with vitD levels.

Conclusion

The percentage of patients with low-vitD levels was as high as 88.2% while 50% were suffering from osteopenia/osteoporosis. The vitD levels were not correlated with any disease characteristic or previous ileocolonic resection and were independent of patients’ age and sex. No correlation of endoscopic disease activity and vitD levels was also found. Finally, it could be suggested that vitD levels should be included in the biochemical exams’ panel during monitoring of IBD patients irrespectively of their disease characteristics.