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

  • Arjun Datt Law
  • Usha DuttaEmail author
  • Rakesh Kochhar
  • Chetana Vaishnavi
  • Shiva Kumar
  • Talha Noor
  • Sanjay Bhadada
  • Kartar Singh
Original Article

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.

Keywords

Disease severity Ulcerative colitis Vitamin D deficiency 

Notes

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.

Compliance with ethical standards

Conflict of interest

ADL, UD, RK, CV, SK, TN, SB, and KS declare that they have no conflict of interest.

Ethical clearance

The authors declare that the study was performed in a manner conforming to the Helsinki declaration of 1975, as revised in 2000 and 2008 concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

Disclaimer

The authors are solely responsible for the data and the content of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, or the printer/publishers are responsible for the results/findings and content of this article.

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Copyright information

© Indian Society of Gastroenterology 2019

Authors and Affiliations

  • Arjun Datt Law
    • 1
  • Usha Dutta
    • 1
    Email author
  • Rakesh Kochhar
    • 1
  • Chetana Vaishnavi
    • 1
  • Shiva Kumar
    • 1
  • Talha Noor
    • 1
  • Sanjay Bhadada
    • 2
  • Kartar Singh
    • 1
  1. 1.Department of GastroenterologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of EndocrinologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia

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