<p>Relationship Between Vitamin D Deficiency and Disease Activity in Patients with Inflammatory Bowel Disease in Ahvaz, Iran</p>

Abstract

Background and Aims: Previous studies have shown that vitamin D plays an important role in inflammatory bowel disease (IBD). This study was designed to investigate the relationship between vitamin D levels and disease activity in IBD patients in Ahvaz, Iran. Methods: This cross-sectional study was conducted on adult IBD patients referring to the outpatient clinic of gastroenterology at Imam Khomeini Hospital in Ahvaz city, in the southwest of Iran. Each patient's disease activity defined according to Crohn's disease activity index (CDAI) in Crohn's disease (CD) and Truelove score in ulcerative colitis (UC) patients, serum 25[OH]D was measured using the radioimmunoassay method. Vitamin D deficiency was defined as concentration of <20 nmol/L. Results: Studied subjects were 130 UC and 23 CD patients (62.1% females) with a mean age of 37.5 ± 12.35 years. Vitamin D deficiency was present in 99 (64.7%) IBD patients. Fifty-three patients (34.6%) had active disease who, compared with patients in remission, had more frequent low vitamin D levels (80 vs 56.7%, P = 0.017). In UC patients, disease activity was significantly associated with vitamin D deficiency (P = 0.035), but no such relationship was observed in CD patients (P = 0.74). Conclusion: Vitamin D deficiency was significantly associated with disease activity in IBD, especially in UC patients. Therefore, careful monitoring of vitamin D deficiency in these patients is highly recommended. Prospective cohort studies are also needed to determine the role of vitamin D deficiency and its treatment in the clinical course of IBD.

Tuberculosis and Autoimmunity

“…Vitamin D insufficiency is associated with AID development such as MS [52,53,57], RA [54][55][56][57], insulin-dependent diabetes mellitus [51], and IBD [53,[57][58][59]217] (Table 2). The role of vitamin D in autoimmune diseases was reviewed by [57,60,186].…”

“…High titers of various AABs are present in pulmonary TB patients with vitamin D deficiency [48][49][50][51]. Vitamin D deficiency was registered in multiple sclerosis (MS) [52,53], rheumatoid arthritis (RA) [54][55][56][57], and inflammatory bowel disease [53,[57][58][59]. The role of vitamin D in autoimmune diseases was demonstrated in [57,60].…”

The Role of Vitamin D in Immune System and Inflammatory Bowel Disease

“… 165 In addition, Ko et al found a negative correlation between disease activity and vitamin D levels in CD but not in UC patients, 74 and Rasouli et al showed that patients with active disease are more likely to have low vitamin D levels than those in UC remission. 77 Moreover, serum bioactive vitamin D status was inversely correlated with fecal calprotectin (FC) during IBD, but not with systemic inflammation markers such as CRP, white cell count, and platelet count, indicating that vitamin D correlated negatively with intestinal but not systemic inflammation. 166 Other studies have also shown a highly inverse correlation between vitamin D concentration and disease activity ( Table 2 ).…”

Can vitamin D induce remission in patients with inflammatory bowel disease?

“…When produced by plants and fungus, it is named ergocalciferol (VD2), and when produced in the skin, it is called cholecalciferol (VD3): 1,25-dihydroxyvitamin D3 1,25(OH)2D3. The active form, 1,25 (OH)2D3, is associated with biological effects [ 7 , 8 ].…”