Department of Internal Medicine, Division of Infectious Diseases, East Tennessee State University, Johnson City, Tennessee, USA.
Geriatr Gerontol Int. 2012 Jul;12(3):475-80. doi: 10.1111/j.1447-0594.2011.00798.x. Epub 2012 Jan 10.
Vitamin D deficiency is a global health issue associated with increased health-care costs, and could play a role in the pathogenesis and management of inflammatory bowel disease. Prior studies show a high prevalence of vitamin D deficiency in veterans with inflammatory bowel disease. We aimed to examine the outcome differences in patients with inflammatory bowel disease, comparing treatment with ergocalciferol to cholecalciferol.
A retrospective review of electronic medical records of patients with inflammatory bowel disease at a Veterans Affairs Medical Facility in the Southeastern United States was carried out. Those with at least one serum 25(OH) vitamin D level were included. Initial and follow-up vitamin D values were recorded. The type of vitamin D supplementation, whether cholecalciferol or ergocalciferol, was documented. Costs in the year after measurement of vitamin D were divided into separate inpatient and outpatient categories.
Veterans (n = 108) with ulcerative colitis or Crohn's disease and an available 25(OH) vitamin D level were studied. There were differences in follow-up vitamin D levels; those who received weekly ergocalciferol had higher subsequent levels than those who received cholecalciferol, especially at a second follow up, although differences did not achieve statistical significance. However, those who received vitamin D3 were less likely to use laboratory, pharmacy, radiology and fee-based services, and had lower laboratory and pharmacy costs.
Our data suggest that cholecalciferol replacement might improve outcomes to a greater extent than ergocalciferol, and might be better in limiting health-care costs and expenses in patients with inflammatory bowel disease.
维生素 D 缺乏是一个全球性的健康问题，与医疗保健费用增加有关，并且可能在炎症性肠病的发病机制和治疗中发挥作用。先前的研究表明，患有炎症性肠病的退伍军人中维生素 D 缺乏的患病率很高。我们旨在研究炎症性肠病患者的治疗结果差异，比较使用骨化二醇和胆钙化醇治疗的效果。
对美国东南部退伍军人事务医疗设施的炎症性肠病患者的电子病历进行了回顾性分析。纳入至少有一次血清 25(OH)维生素 D 水平的患者。记录初始和随访时的维生素 D 值。记录维生素 D 补充的类型，是胆钙化醇还是骨化二醇。测量维生素 D 后一年内的费用分为住院和门诊两类。
研究了患有溃疡性结肠炎或克罗恩病且有可用的 25(OH)维生素 D 水平的退伍军人（n = 108）。随访时维生素 D 水平存在差异；每周接受骨化二醇治疗的患者随后的水平高于接受胆钙化醇治疗的患者，尤其是第二次随访时，尽管差异未达到统计学意义。然而，接受维生素 D3 治疗的患者使用实验室、药房、放射科和收费服务的可能性较低，且实验室和药房费用较低。
我们的数据表明，胆钙化醇替代治疗可能比骨化二醇更能改善治疗效果，并且在限制炎症性肠病患者的医疗保健费用和支出方面可能更好。
