Ye Lingna, Lin Ziwen, Liu Jing, Cao Qian
Department of Gastroenterology, Xiasha Branch of Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Inflammatory Bowel Disease Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Gastroenterol Res Pract. 2017;2017:4869718. doi: 10.1155/2017/4869718. Epub 2017 Nov 16.
Vitamin D deficiency is common in patients with Crohn's disease and is associated with disease activity. Relationship between vitamin D and endoscopic disease activity is unknown. The aim of the study is to determine the association between vitamin D status and endoscopic disease activity in CD patients.
Consecutive hospitalized CD patients from 2014 to 2016 who received vitamin D assessment and colonoscopy were retrospectively evaluated. Clinical disease activity was assessed by Crohn's disease activity index and C-reactive protein. Endoscopic activity was calculated using simple endoscopic score for Crohn's disease.
Median serum 25OHD level of 131 patients was lower than healthy controls [21.1 nmol/L (11.8-32.3) versus 49.9 nmol/L (44.9-57.4), = 0.007]. 125 (95%) patients had vitamin D deficiency and the rest (5%) had vitamin D insufficiency. Serum 25OHD was inversely correlated with CRP ( = -0.308, < 0.001), CDAI ( = -0.582, < 0.001), SES-CD ( = -0.294, = 0.001), and endoscopic severity stratified by SES-CD ( = 0.001).
Vitamin D deficiency was prevalent among hospitalized CD patients. Vitamin D levels were inversely correlated with endoscopic disease activity. Vitamin D status could be a biomarker in assessing disease activity among hospitalized CD patients in addition to CDAI and CRP.
维生素D缺乏在克罗恩病患者中很常见,且与疾病活动相关。维生素D与内镜下疾病活动之间的关系尚不清楚。本研究的目的是确定克罗恩病患者维生素D状态与内镜下疾病活动之间的关联。
对2014年至2016年连续住院且接受维生素D评估和结肠镜检查的克罗恩病患者进行回顾性评估。通过克罗恩病活动指数和C反应蛋白评估临床疾病活动。使用克罗恩病简单内镜评分计算内镜活动度。
131例患者的血清25羟维生素D水平中位数低于健康对照[21.1纳摩尔/升(11.8 - 32.3)对49.9纳摩尔/升(44.9 - 57.4),P = 0.007]。125例(95%)患者存在维生素D缺乏,其余(5%)存在维生素D不足。血清25羟维生素D与CRP(r = -0.308,P < 0.001)、CDAI(r = -0.582,P < 0.001)、SES - CD(r = -0.294,P = 0.001)以及按SES - CD分层的内镜严重程度(P = 0.001)呈负相关。
住院的克罗恩病患者中维生素D缺乏普遍存在。维生素D水平与内镜下疾病活动呈负相关。除了CDAI和CRP外,维生素D状态可能是评估住院克罗恩病患者疾病活动的一个生物标志物。