Gubatan John, Moss Alan C
Division of Gastroenterology and Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Curr Opin Gastroenterol. 2018 Jul;34(4):217-225. doi: 10.1097/MOG.0000000000000449.
The aim of this review is to explore the protective role of vitamin D on the gastrointestinal tract, summarize the epidemiology of vitamin D deficiency in inflammatory bowel disease (IBD), and highlight recent studies examining the impact of low vitamin D and vitamin D supplementation on IBD clinical outcomes.
Vitamin D protects the gut barrier by regulating tight junction proteins and inhibiting intestinal apoptosis. Vitamin D enhances innate immunity by inducing antimicrobial peptides and regulates adaptive immunity by promoting anti-inflammatory T cells and cytokines. Vitamin D may also alter the gut microbiota. The prevalence of vitamin D deficiency in IBD is 30-40%. Predictors of vitamin D deficiency in IBD include non-white ethnicity, IBD-related surgery, BMI more than 30, female sex, and pregnancy. Low vitamin D is associated with increased disease activity, inflammation, and clinical relapse. The effect of vitamin D supplementation on IBD clinical outcomes is inconclusive.
Vitamin D plays a protective role on gut health. Vitamin D deficiency in IBD is prevalent and associated with poor outcomes. The benefits of vitamin D supplementation in IBD is unclear. Measuring novel vitamin D metabolites and vitamin D absorption in IBD patients may help guide future studies.
本综述旨在探讨维生素D对胃肠道的保护作用，总结炎症性肠病（IBD）中维生素D缺乏的流行病学情况，并重点介绍近期研究，这些研究考察了低维生素D水平及补充维生素D对IBD临床结局的影响。
维生素D通过调节紧密连接蛋白和抑制肠道细胞凋亡来保护肠道屏障。维生素D通过诱导抗菌肽增强固有免疫，并通过促进抗炎性T细胞和细胞因子来调节适应性免疫。维生素D还可能改变肠道微生物群。IBD中维生素D缺乏的患病率为30%-40%。IBD中维生素D缺乏的预测因素包括非白种人、IBD相关手术、BMI大于30、女性以及妊娠。低维生素D水平与疾病活动度增加、炎症及临床复发相关。补充维生素D对IBD临床结局的影响尚无定论。
维生素D对肠道健康起保护作用。IBD中维生素D缺乏很普遍且与不良结局相关。补充维生素D在IBD中的益处尚不清楚。检测IBD患者新型维生素D代谢产物及维生素D吸收情况可能有助于指导未来研究。
