Department of Internal Medicine and Medical Specialties, Gastroenterology, Sapienza University of Rome, Rome, Italy.
Department of Internal Medicine and Medical Specialties, Gastroenterology, Sapienza University of Rome, Rome, Italy.
Dig Liver Dis. 2019 May;51(5):657-662. doi: 10.1016/j.dld.2018.11.036. Epub 2018 Dec 7.
Hypovitaminosis D is prevalent in inflammatory bowel disease (IBD) and may be associated with disease activity.
This study evaluated vitamin D (VitD) status in an Italian cohort of IBD patients, not taking VitD supplementation. We investigated risk factors for VitD deficiency and its correlation with disease activity.
VitD levels were measured in 300 consecutive outpatients (42% with Crohn's Disease (CD) and 58% with ulcerative colitis (UC), 56% male) from a tertiary referral center. Data from the IBD cohort were compared with those of 234 healthy controls, matched by sex, age, and the month in which VitD levels were measured.
The mean VitD level in IBD patients was significantly lower than in controls (18.9 ng/ml vs. 25 ng/ml, p < 0.001) when accounting for gender, age, and season. VitD deficiency was present in 62% of IBD patients. Risk factors for deficiency were: age <40 and ≥60 years, winter, previous surgery, C-reactive protein (CRP) ≥0.5 mg/dl, and erythrocyte sedimentation rate ≥20 mm/h. In multivariate analysis, VitD levels were negatively influenced by disease location and CRP in UC.
Although VitD deficiency was more prevalent than expected in healthy controls living in a Mediterranean country not at high risk of hypovitaminosis D, it was more common and severe in IBD patients. This study also found an association between VitD status and disease activity.
维生素 D 缺乏在炎症性肠病（IBD）中很常见，并且可能与疾病活动有关。
本研究评估了意大利 IBD 患者队列中未接受维生素 D（VitD）补充的 VitD 状态。我们研究了 VitD 缺乏的危险因素及其与疾病活动的相关性。
从一家三级转诊中心招募了 300 名连续门诊患者（42%患有克罗恩病（CD），58%患有溃疡性结肠炎（UC），56%为男性），测量其 VitD 水平。将 IBD 队列的数据与 234 名性别、年龄和测量 VitD 水平的月份相匹配的健康对照者的数据进行比较。
当考虑性别、年龄和季节时，IBD 患者的平均 VitD 水平明显低于对照组（18.9ng/ml 与 25ng/ml，p<0.001）。IBD 患者中有 62%存在 VitD 缺乏。缺乏的危险因素为：年龄<40 岁和≥60 岁、冬季、既往手术、C 反应蛋白（CRP）≥0.5mg/dl 和红细胞沉降率≥20mm/h。多变量分析显示，UC 中 VitD 水平受疾病部位和 CRP 的负性影响。
尽管维生素 D 缺乏在居住在不易发生维生素 D 缺乏的地中海国家的健康对照者中比预期更为普遍，但在 IBD 患者中更为常见且更为严重。本研究还发现 VitD 状态与疾病活动之间存在关联。
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