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Vitamin D deficiency in adult patients with ulcerative colitis: Prevalence and relationship with disease severity, extent, and duration

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Abstract

Background

Vitamin D plays a key role in gut immunity and maintenance of the mucosal barrier. Vitamin D deficiency (VDD) worsens ulcerative colitis (UC) and its supplementation ameliorates the disease in mouse models. The prevalence and predictors of VDD in UC are not known.

Methods

Consecutive patients with UC (n = 80) underwent clinical, endoscopic, and histological evaluation to assess the extent, severity using UC disease activity index (UCDAI) score, and duration of illness. An equal number of age and gender-matched healthy adults without any features of inflammatory bowel disease (IBD) living in the same latitude were identified as controls. The serum 25-hydroxy vitamin D3 level was estimated. The subjects were classified as deficient (< 20 ng/mL), insufficient (20–32 ng/mL), sufficient (32–80 ng/mL), and optimal (> 80 ng/mL) based on vitamin D levels. Chi-square test and Mann-Whitney U test were done to identify factors associated with vitamin D deficiency.

Results

The patients and controls were similar in age and gender (40 ± 11.4 years, 51% male vs. 40 ± 12 years, 51% male; p = 1.000). Median vitamin D levels among patients were lower than the controls (18.1 ng/mL [IQR 14] vs. 32.5 ng/mL [IQR 36]; p < 0.001). Patients were more often VDD (56% vs. 40%) or insufficient (34% vs. 9%) and less often sufficient (9% vs. 40%) or optimal (1% vs. 11%), in contrast to controls (p < 0.001). Median vitamin D levels were lower in those with UCDAI > 6 (15 vs. 21 ng/mL; p = 0.01), having pancolitis (13 vs. 21 ng/mL, p = 0.01), and longer duration of illness > 2 years (13.8 vs. 20.8; p = 0.025). Vitamin D levels showed a negative correlation with frequency of stools (rho = − 0.244, p = 0.05), disease duration (rho = − 0.244, p = 0.007) and UCDAI score (r = − 0.348, p = 0.002).

Conclusion

VDD is highly prevalent among patients with UC. Patients with longer disease duration, more severe symptoms, and pancolitis are likely to have lower vitamin D levels.

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Acknowledgments

We would like to acknowledge the efforts of Dr. Sharonjeet Kaur, Anu Sharma, and Neha Thakur for their assistance in data compilation and preparation of the manuscript.

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Authors and Affiliations

  1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Arjun Datt Law, Usha Dutta, Rakesh Kochhar, Chetana Vaishnavi, Shiva Kumar, Talha Noor & Kartar Singh

  2. Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Sanjay Bhadada

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  1. Arjun Datt Law
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Correspondence to Usha Dutta.

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Law, A.D., Dutta, U., Kochhar, R. et al. Vitamin D deficiency in adult patients with ulcerative colitis: Prevalence and relationship with disease severity, extent, and duration. Indian J Gastroenterol 38, 6–14 (2019). https://doi.org/10.1007/s12664-019-00932-z

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