Correlation between serum vitamin D levels and inflammatory bowel disease
DOI:
https://doi.org/10.62827/nb.v24i1.3055Keywords:
Biomarkers; Ulcerative; Crohn’s Disease; Inflammation; Vitamin D.Abstract
Introduction: Inflammatory bowel diseases are characterized by chronic intestinal inflammation triggered by a disordered immune reaction, the most common being Crohn's disease (CD) and ulcerative colitis (UC). Objective: To verify the correlation between inflammatory activity measured by clinical and laboratory indices and serum vitamin D (VD) levels. Methods: The sample consisted of adults with inflammatory bowel disease, of both sexes. The inflammatory activity of UC and CD were assessed by the Truelove & Witts and Crohn’s disease Activity Index (CDAI), respectively. The serum biomarkers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and VD were measured. Stool was collected for determination of fecal calprotectin. Results: A total of 111 patients participated, 55.9% with CD, 63.1% female, aged between 18 and 75 years. Most individuals were considered without disease activity according to clinical indices. The mean serum VD in the total sample was 21.8±11 ng/mL, and only 21.6% had sufficient levels of this vitamin. VD values were higher in the UC group compared to the CD group (p=0.02). There was no significant correlation between the variables fecal calprotectin (p=0.095) and CDAI (p=0.627) and VD. There was a significant correlation between the variables ESR (p=0.05), CRP (p=<0.001), and Truelove & Witts index (p=0.02) and VD. Patients with sufficient VD levels had lower CRP and ESR values in both IBDs. Conclusion: Patients with sufficient serum levels of VD have a lower correlation with disease activity in the evaluated indices and biomarkers.
References
Brazilian Study Group of Inflammatory Bowel Diseases. Consensus guidelines for the management of inflammatory bowel disease. Arq Gastroenterol [internet]. 2010 Jul-Sep [cited 2025 Feb 12];47(3):313-25. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032010000300019. doi: 10.1590/S0004-28032010000300019
Ananthakrishnan AN. Epidemiology and risk factors for IBD. Nat Rev Gastroenterol Hepatol [internet]. 2015 Apr [cited 2025 Feb 12];12(4):205-17. Available from: https://www.nature.com/nrgastro/journal/v12/n4/pdf/nrgastro.2015.34.pdf. doi: 10.1038/nrgastro.2015.34
Oliveira FM, Emerick APdC, Soares EG. Aspectos epidemiológicos das doenças intestinais inflamatórias na macrorregião de saúde leste do Estado de Minas Gerais [Epidemiology aspects of inflammatory bowel disease in the east region of Minas Gerais State]. Ciênc saúde coletiva [internet]. 2010 June [cited 2025 Feb 15];15(1):1031-7. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232010000700009. Portuguese. Doi: 10.1590/S1413-81232010000700009.
Torres JAdP, de Santana RM, Torres FAdP, Moura AR, Torres Neto JdR. Doenças inflamatórias intestinais no Hospital Universitário da Universidade Federal de Sergipe: manifestações extraintestinais [Intestinal inflammatory diseases in the Hospital Universitario of Universidade Federal de Sergipe: extraintestinal manifestations]. Rev bras. colo-proctol [internet]. 2011 Apr-June [ cited 2025 Feb 15]; 31(2):115-9. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0101-98802011000200001. Portuguese.
Hansen JJ. Immune Responses to Intestinal Microbes in Inflammatory Bowel Diseases. Curr Allergy Asthma Rep. 2015 Oct;15(10):562.
Farrukh A, Mayberry JF. Inflammatory bowel disease in Hispanic communities: a concerted South American approach could identify the aetiology of Crohn's disease and ulcerative colitis. Arq Gastroenterol [internet]. 2014 Oct-Dec [ cited 2025 Feb 15];51(4):271-5. Available from: http://www.scielo.br/pdf/ag/v51n4/0004-2803-ag-51-04-271.pdf. doi: 10.1590/S0004-28032014000400002
World Gastroenterology Organisation Global Guidelines. Inflammatory bowel disease: a global perspective [internet]. 2009. [cited 2025 Feb 15] 24 p. Available from: http://www.worldgastroenterology.org/guidelines/global-guidelines/inflammatorybowel-disease-ibd/inflammatory-bowel-disease-ibd-english2009
Park SJ, Kim WH, Cheon JH. Clinical characteristics and treatment of inflammatory bowel disease: a comparison of Eastern and Western perspectives. World J Gastroenterol [internet]. 2014 Sep [ cited 2025 Feb 15];20(33):11525-37. Available from: https:// https://pmc.ncbi.nlm.nih.gov/articles/PMC4155345/. doi: 10.3748/wjg.v20.i33.11525
Parente JML, Coy CSR, Campelo V, Parente MPPD, Costa LA, da Silva RM, et al. Inflammatory bowel disease in an underdeveloped region of Northeastern Brazil. World J Gastroenterol [internet]. 2015 Jan [cited 2025 Feb 15];21(4):1197-206. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306164/pdf/WJG-21- 1197.pdf. doi: 10.3748/wjg.v21.i4.1197
Wöbke TK, Sorg BL, Steinhilber D. Vitamin D in inflammatory diseases. Front Physiol [internet]. 2014 [cited 2025 Feb 13];5:244. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078458/pdf/fphys-05-00244.pdf. doi: 10.3389/fphys.2014.00244
Cantorna MT. Why do T cells express the vitamin D receptor? Ann N Y Acad Sci [internet]. 2011 Jan [cited 2025 Feb 13];1217:77-82. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129658/pdf/nihms274117.pdf. doi: 10.1111/j.1749-6632.2010.05823.x
Blanck S, Aberra F. Vitamin d deficiency is associated with ulcerative colitis disease activity. Dig Dis Sci [internet]. 2013 Jun [cited 2025 Feb 11];58(6):1698-702. Available from: https://link.springer.com/article/10.1007%2Fs10620-012-2531-7. doi: 10.1007/s10620-012-2531-7.
Suibhne TN, Cox G, Healy M, O'Morain C, O'Sullivan M. Vitamin D deficiency in Crohn's disease: prevalence, risk factors and supplement use in an outpatient setting. J Crohns Colitis. 2012 Mar [cited 2025 Feb 11];6(2):182-8. Available from: https://pubmed.ncbi.nlm.nih.gov/22325172/. doi: 10.1016/j.crohns.2011.08.002
Ulitsky A, Ananthakrishnan AN, Naik A, Skaros S, Zadvornova Y, Binion DG, et al. Vitamin D deficiency in patients with inflammatory bowel disease: association with disease activity and quality of life. JPEN J Parenter Enteral Nutr [internet]. 2011 May [cited 2025 Feb 11];35(3):308-16. Available from: http://journals.sagepub.com/doi/abs/10.1177/0148607110381267?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed. Doi: 10.1177/0148607110381267
Dumitrescu G, Mihai C, Dranga M, Prelipcean CC. Serum 25-hydroxyvitamin D concentration and inflammatory bowel disease characteristics in Romania. World J Gastroenterol [internet]. 2014 Mar [cited 2025 Nov 12];20(9):2392-6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3942843/pdf/WJG-20-2392.pdf. doi: 10.3748/wjg.v20.i9.2392.
Martín RVo, Molero IG, Fuster GO, Trillo VA, Pérez MJ. Vitamin D deficiency in outpatients with inflammatory bowel disease: prevalence and association with clinical-biological activity. Rev Esp Enferm Dig [internet]. 2019 Jan [cited 2025 Feb 15];111(1):46-54. Available from: https://pubmed.ncbi.nlm.nih.gov/30284908/. doi: 10.17235/reed.2018.5714/2018
Ardesia M, Ferlazzo G, Fries W. Vitamin D and inflammatory bowel disease. Biomed Res Int [internet]. 2015 [cited 2025 Feb 15];2015:470805. Available from: https://www.hindawi.com/journals/bmri/2015/470805/. doi: 10.1155/2015/470805
Castro FD, Magalhães J, Carvalho PB, Moreira MJ, Mota P, Cotter J. Lower levels of vitamin d correlate with clinical disease activity and quality of life in inflammatory bowel disease. Arq Gastroenterol [internet]. 2015 Dec [cited 2025 Feb 13];52(4):260-5. Available from: http://www.scielo.br/pdf/ag/v52n4/0004-2803-ag-52-04-00260.pdf. doi: 10.1590/S0004-28032015000400003
Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J [internet]. 1955 Oct [ cited 2025 Feb 15];2(4947):1041-8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1981500/pdf/brmedj03231-0011.pdf.
Sociedade Brasileira de Coloproctologia; Colégio Brasileiro de Cirurgia Digestiva; Sociedade Brasileira de Patologia; Colégio Brasileiro de Radiologia. [Intestinal Crohn’s disease: management]. Rev. Assoc. Med. Bras [internet]. 2011 Jan Feb [ cited 2025 Feb 15]; 57(1):10-3. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302011000100006. English, Portuguese. doi: 10.1590/S0104-42302011000100006
Ministério da agricultura e pecuária (BR). Instituto Nacional de Meteorologia [internet]. Brasília: Distrito Federal. Data e horário de início das estações do ano; [cited 2025 Mar 02]. Available from: https://portal.inmet.gov.br/.
Montalto M, Gallo A, Santoro L, D'Onofrio F, Landolfi R, Gasbarrini A. Role of fecal calprotectin in gastrointestinal disorders. Eur Rev Med Pharmacol Sci [internet]. 2013 Jun [cited 2025 Feb 15];17(12):1569-82. Available from: http://www.europeanreview.org/wp/wp-content/uploads/1569-1582.pdf.
Razali NM, Wah YB. Power comparisons of Shapiro-Wilk, KolmogorovSmirnov, Lilliefors and Anderson-Darling tests. Journal of Statistical Modeling and Analytics [internet]. 2011 [cited 2025 Feb 12];2(1):21-33. Available from: http://www.de.ufpb.br/~ulisses/disciplinas/normality_tests_comparison.pdf
Raftery T, Merrick M, Healy M, Mahmud N, O'Morain C, Smith S, et al. Vitamin D Status Is Associated with Intestinal Inflammation as Measured by Fecal Calprotectin in Crohn's Disease in Clinical Remission. Dig Dis Sci. 2015 Aug;60(8):2427-35. doi: 10.1007/s10620-015-3620-1.
Vidarsdottir JB, Johannsdottir SE, Thorsdottir I, Bjornsson E, Ramel A. A crosssectional study on nutrient intake and status in inflammatory bowel disease patients. Nutr J [internet]. 2016 Jun [cited 2024 Nov 20];15(1):61. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897945/pdf/12937_2016_Article_178.pdf. doi: 10.1186/s12937-016-0178-5
Souza H, Lora F, Kulak C, Mañas N, Amarante H, Borba V. Níveis baixos de 25-hidroxivitamina D (25OHD) em pacientes com doença inflamatória intestinal e sua correlação com a densidade mineral óssea [Low levels of 25-hydroxyvitamin D (25OHD) in patients with inflammatory bowel disease and its correlation with bone mineral density]. Arq Bras Endocrinol Metab [internet]. 2008 [cited 2016 Nov 23]; 52:684-91. Available from: http://www.scielo.br/pdf/abem/v52n4/a15v52n4.pdf. Portuguese.
Frota K. Ponto de corte para adequação da concentração sérica de 25 hidroxivitamina D em adultos e idosos: estudo de base populacional - ISA – Capital [dissertação on the Internet]. São Paulo: Universidade de São Paulo; 2012 [cited 2024 Nov 20]. Available from: http://www.teses.usp.br/teses/disponiveis/6/6138/tde- 05092012-102812/pt-br.php.
Maeda SS, Saraiva GL, Hayashi LF, Cendoroglo MS, Ramos LR, Corrêa MdP, et al. Seasonal variation in the serum 25-hydroxyvitamin D levels of young and elderly active and inactive adults in São Paulo, Brazil: The São Paulo Vitamin D Evaluation Study (SPADES). Dermatoendocrinol [internet]. 2013 Jan [cited 2016 Nov 20];5(1):211-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897593/pdf/de-5-211.pdf. Doi: 10.4161/derm.24476
Raftery T, O'Sullivan M. Optimal vitamin D levels in Crohn's disease: a review. Proc Nutr Soc [internet]. 2015 Feb [cited 2024 Nov 20];74(1):56-66. Available from: https://pubmed.ncbi.nlm.nih.gov/25497215/. doi: 10.1017/S0029665114001591.
Jørgensen SP, Hvas CL, Agnholt J, Christensen LA, Heickendorff L, Dahlerup JF. Active Crohn's disease is associated with low vitamin D levels. J Crohns Colitis [internet]. 2013 Nov [cited 2016 Nov 26];7(10):e407-13. Available from: https://academic.oup.com/ecco-jcc/article-lookup/doi/10.1016/j.crohns.2013.01.012. doi: 10.1016/j.crohns.2013.01.012
Hassan V, Hassan S, Seyed-Javad P, Ahmad K, Asieh H, Maryam S, et al. Association between Serum 25 (OH) Vitamin D Concentrations and Inflammatory Bowel Diseases (IBDs) Activity. Med J Malaysia [internet]. 2013 [cited 2024 Nov 20];68(1):34-8. Available from: https://pubmed.ncbi.nlm.nih.gov/23466764/
López-Muñoz P, Beltrán B, Sáez-González E, Alba A, Nos P, Iborra M. Influence of Vitamin D Deficiency on Inflammatory Markers and Clinical Disease Activity in IBD Patients. Nutrients [internet]. 2019 May [cited 2025 Mar 17]; 11;11(5):1059. doi: 10.3390/nu11051059.
Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut [internet]. 2006 Mar [cited 2016 Dec 2];55(3):426-31. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856093/pdf/426.pdf. doi: 10.1136/gut.2005.069476.
Aguiar FJ, Ferreira-Júnior M, Sales MM, Cruz-Neto LM, Fonseca LA, Sumita NM, et al. C-reactive protein: clinical applications and proposals for a rational use. Rev Assoc Med Bras [internet]. 2013 Jan-Feb [cited 2025 Feb 2];59(1):85-92. Available from: http://www.scielo.br/pdf/ramb/v59n1/en_v59n1a16.pdf. English, Portuguese.
Garg M, Rosella O, Lubel JS, Gibson PR. Association of circulating vitamin D concentrations with intestinal but not systemic inflammation in inflammatory bowel disease. Inflamm Bowel Dis [internet]. 2013 Nov [cited 2025 Feb 2];19(12):2634-43. Available from: https://pubmed.ncbi.nlm.nih.gov/24105392/. doi: 10.1097/01.MIB.0000436957.77533.b2
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