Ayadi Shema, Ayari Myriam, Bahlous Afef, Zaimi Yosra, Bel Hadj Mabrouk Emna, Mouelhi Leila, Debbeche Radhouane
Department of Gastro-enterology, Charles Nicolle hospital, Tunis.
Faculty of medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Tunis Med. 2023 Dec 5;101(12):907-911.
Vitamin D plays a role in regulating the immune response through an immunomodulatory effect, and is probably involved in the pathophysiology of Crohn's disease (CD).
to assess vitamin D status in patients with CD as well as in healthy controls and to determine associated factors of vitamin D deficiency in patients with CD.
We conducted a prospective study over 18 months, including CD patients with age and sex matched with healthy controls. Suboptimal vitamin D status was defined by vitamin D serum level < 30 ng/ml, vitamin insufficiency by vitamin D serum level between 10 and 30 ng/ml and vitamin deficiency serum level < 10 ng/ml.
We included 77 subjects (52 patients with CD and 25 controls) with mean age of 38 years± 11. Most patients and controls had suboptimal levels of vitamin D (98% and 96% respectively) including vitamin D deficiency in 75% and 67%, respectively and vitamin D insufficiency in 25% and 33%, respectively. In univariate analysis, vitamin D deficiency was associated with disease flare-up (p=0.001), anemia (p=0.002), hypo-albuminemia (p=0.002), elevated C-reactive protein (CRP) (p=0.003), Crohn's Disease Activity Index (CDAI) (p<0.001), ileal location (p=0.04) and immunosuppressive therapy (p=0.01). In multivariate analysis, only CDAI was significantly associated with vitamin D deficiency (p=0.003, OR=9.33).
Vitamin D deficiency is common in Tunisian CD patients as well as in controls and is associated with disease activity.
维生素D通过免疫调节作用在调节免疫反应中发挥作用，可能参与克罗恩病（CD）的病理生理过程。
评估CD患者以及健康对照者的维生素D状态，并确定CD患者维生素D缺乏的相关因素。
我们进行了一项为期18个月的前瞻性研究，纳入年龄和性别与健康对照者相匹配的CD患者。维生素D状态不佳定义为血清维生素D水平<30 ng/ml，维生素不足定义为血清维生素D水平在10至30 ng/ml之间，维生素缺乏定义为血清水平<10 ng/ml。
我们纳入了77名受试者（52例CD患者和25名对照者），平均年龄为38岁±11岁。大多数患者和对照者的维生素D水平不佳（分别为98%和96%），其中维生素D缺乏分别为75%和67%，维生素D不足分别为25%和33%。单因素分析显示，维生素D缺乏与疾病发作（p=0.001）、贫血（p=0.002）、低白蛋白血症（p=0.002）、C反应蛋白（CRP）升高（p=0.003）、克罗恩病活动指数（CDAI）（p<0.001）、回肠部位（p=0.04）和免疫抑制治疗（p=0.01）相关。多因素分析显示，只有CDAI与维生素D缺乏显著相关（p=0.003，OR=9.33）。
维生素D缺乏在突尼斯CD患者和对照者中都很常见，并且与疾病活动相关。
