P658 Is vitamin D deficiency related to fat malabsorption or inflammation in Inflammatory Bowel Disease? Preliminary results from the Fat-D study

Abstract Background Vitamin D deficiency is highly prevalent in patients with inflammatory bowel disease (IBD). The question of whether vitamin D status is a contributory factor or a consequence of IBD, or maybe both, remains unanswered, and is confounded by the complexity of inflammation, IBD and vitamin D. Fat malabsorption has been proposed as a possible reason for deficiencies of vitamin D in IBD. The aim of this study was to further understanding of vitamin D deficiency in IBD by investigating possible causal relationships of fat malabsorption and inflammation on vitamin D levels in this complex context. Methods In a comparative, cross-sectional study in IBD patients, 25(OH)D was analysed by LCMS/MS. Serum β-carotene levels were used as a biomarker for fat malabsorption. Vitamin K1, another fat-soluble vitamin, was used to affirm a possible causative relation between β-carotene and vitamin D in case of fat malabsorption. β-carotene and vitamin K were measured in serum by HPLC. Inflammation was characterised by serum hsCRP<5mg/L. Results 51 IBD patients (30f;20CD/18UC;45.3±16.3y; 21 with inflammatory activity) were enrolled. In patients with vs. without inflammation, serum 25(OH)D levels were significantly lower (26.5±14.6ng/mL vs. 36.8±12.6ng/mL, p<0.05), while serum vitamin K1 (1.4±0.5µg/L vs. 1.2±0.4µg/L) and β-carotene (28.5±0.6.0µg/dL vs. 35.9±5.4µg/dL) levels were similar (p>0.05). 36/51 of the patients had low serum β-carotene levels, indicating steatorrhoea. Neither 25(OH)D (32.1.5±13.8ng/mL vs. 33.6±15.8ng/mL) nor vitamin K1 (1.3±0.5µg/L vs. 1.2±0.4µg/L) levels differed according to the presence vs. absence of steatorrhoea (p>0.05). Similarly, no correlation was found for 25(OH)D (r=0.024, p=0.875) or serum vitamin K1 (r=0.111, p=0.462) with β-carotene levels. On the other hand, 25(OH)D levels were significantly inversely correlated with hsCRP (r=-0.338, p=0.015), whereas vitamin K1(r=0.050, p=0.731) and β-carotene (r=-0.118, p=0.438) did not show a similar relation. Conclusion Vitamin D levels were confirmed to be related to inflammation in IBD. A lack of correlation with fat malabsorption, as indicated by β-carotene levels, or with steatorrhoea, was found for vitamin D and confirmed by measuring and comparing serum levels of an additional fat-soluble vitamin, K1. We conclude that low vitamin D levels in patients with IBD are related to inflammation rather than fat malabsorption.

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AB1281-HPR THE LEVELS OF VITAMIN D IN THE SPONDYLOARTHRITIS. DOES THE DEFICIT CORRESPOND TO THE INFLAMMATORY ACTIVITY?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.1637 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1931.1-1931

Author(s):

D. Castro-Corredor ◽

M. A. Ramírez Huaranga ◽

A. I. Rebollo Giménez ◽

M. D. Mínguez Sánchez ◽

J. Anino-Fernández ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Vitamin D ◽

Ankylosing Spondylitis ◽

Disease Activity ◽

Vitamin D Deficiency ◽

Bowel Disease ◽

Inflammatory Activity ◽

Mineral Density ◽

Vitamin D Levels ◽

Inflammatory Bowel

Background:Spondyloarthritis is a group of chronic inflammatory diseases with involvement of the axial skeleton (mainly), and also of peripheral joints. Patients with spondyloarthritis have a significant prevalence of vitamin D levels below normal and that would correlate with the degree of activity of the disease.Objectives:To determine the association between vitamin D deficiency and the degree of activity of the disease (inflammatory activity) in a cohort of patients with spondyloarthritis.Methods:Case-control type analytical observational study. We propose a retrospective review of the database of patients with spondyloarthritis (according ASAS2010 criteria) who were treated in the outpatient clinics of the Rheumatology Service of the General University Hospital of Ciudad Real during June 2018 to June 2019. Patients with the data will be selected. necessary for the analysis of the variables under study. The numerical variables of normal distribution evaluated will be described using measures of frequency and measures of central tendency / dispersion as appropriate. To assess the association between vitamin D levels and activity index, the odds ratio (OR) is calculated, with a 95% confidence level and the T-student for related samples.Results:The final results of the study are presented. 115 patients were analyzed, of which 64 were men and 51 women, with an average age of 45.97 years (+/- 13.41 DE). 47% were ankylosing spondylitis, 21% psoriatic arthropathy, 16% undifferentiated spondyloarthritis, 7% spondyloarthropathy associated with inflammatory bowel disease and 9% were spondyloarthropathy associated with inflammatory bowel disease. The average of the activity was a BASDAI of 4.57 (+/- 2.35 SD) and measured by DAPSA was 12.61 (+/- 6.76 SD). 63 and 14 patients had activity measured by BASDAI and DAPSA, respectively. 49.56% patients presented an elevation of acute phase reactants. Vitamin D levels were 23.81 (+/- 10.5 SD). 77.4% presented figures of vitamin D deficiency or insufficiency. When performing the association analysis, the vitamin D deficit / insufficiency presented an OR 10 (95% CI: 3.66-27.29, p=<0.0001) with the degree of activity measured with BASDAI and DAPSA and against the elevation of RCP it was 3.63 (95% CI 1.43-9.25, p = 0.0092) and against the elevation of ESR it was 2.76 (95% CI 1.09-7, 0, p = 0.0438). Regarding the comparative analysis of means between vitamin D deficiency/insufficiency and BASDAI/DAPSA it was +3.29 (95% CI: 1.34-8.09, p=0.0084).Conclusion:Patients with spondyloarthritis, as in other autoimmune diseases, vitamin D deficiency is associated with increased inflammatory activity (BASDAI, DAPSA, RCP and ESR), measured in different time periods. Therefore, an optimization of vitamin D levels can imply an improvement in the patient’s clinical situation, measured by both BASDAI and DAPSA, as well as by RCP and ESR.In addition, it is necessary to monitor bone mineral density due to the risk of fracture in these patients for their multietiology (corticosteroid treatments, biological FAMEs, inflammatory activity).References:[1]Lange U, Teichmann J, Strunk J, Müller-Ladner U, Schmidt KL. Association of 1.25 vitamin D3 deficiency, disease activity and low bone mass in ankylosing spondylitis. Osteoporos Int. 2005;16:1999-2004.[2]Durmus B, Altay Z, Baysal O, Ersoy Y. Does vitamin D affect disease severity in patients with ankylosing spondylitis? Chin Med J. 2012;125:2511-2515.[3]Mermerci Baskan B, Pekin Dogan y, Sivas F, Bodur H, Ozoran K. The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis. Rheumatol Int. 2010;30:375-381.Disclosure of Interests:None declared

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VITAMIN D DEFICIENCY AMONG INFLAMMATORYBOWEL DISEASE PATIENTS IN ARGENTINA: A CROSS-SECTIONAL STUDY

Arquivos de Gastroenterologia ◽

10.1590/s0004-2803.201800000-57 ◽

2018 ◽

Vol 55 (3) ◽

pp. 216-220 ◽

Cited By ~ 1

Author(s):

María Constanza TORELLA ◽

Astrid RAUSCH ◽

Juan LASA ◽

Ignacio ZUBIAURRE

Keyword(s):

Inflammatory Bowel Disease ◽

Vitamin D ◽

Hospital Admission ◽

Vitamin D Deficiency ◽

Bowel Disease ◽

Disease Duration ◽

Serum Vitamin ◽

Healthy Controls ◽

Serum Vitamin D ◽

Inflammatory Bowel

ABSTRACT BACKGROUND: An association has been established between low serum values of vitamin D and inflammatory bowel disease. There is a lack of evidence on whether this association is still observed in regions where sun exposure throughout the year is higher. OBJECTIVE: To compare the prevalence of vitamin D deficiency between inflammatory bowel disease patients and healthy controls. METHODS: Inflammatory bowel disease patients were consecutively enrolled as cases. Age and gender-matched healthy subjects who agreed to undertake a determination of serum vitamin D were enrolled as controls. Demographic features, medical treatment, need for hospital admission at diagnosis, steroid treatment, smoking, need for surgical treatment were evaluated as factors associated with vitamin D deficiency. RESULTS: Overall, 59 patients with a diagnosis of either Crohn’s disease or ulcerative colitis were enrolled, as well as 56 controls. Median age was 41 years (19-79) and 56% were male. Vitamin D deficiency was observed in 66.1% of inflammatory bowel disease patients versus 21.42% of healthy controls (OR 7.15 (3.1-16.48), P=0.001). Among inflammatory bowel disease patients, male gender, disease duration, moderate-to-severe disease and hospital admission at the moment of diagnosis were found to be associated with vitamin D deficiency. On multivariate analysis, only longer disease duration [(OR 1.01 (1-1.06)] and hospital admission at diagnosis [(OR 5.63 (1.01-31.61)] were found to be significantly associated with the latter. CONCLUSION: Vitamin D deficiency was more frequent among inflammatory bowel disease patients. Longer disease duration and need for hospital admission at diagnosis were associated to vitamin D deficiency among these patients.

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Vitamin D Deficiency is Associated with Increased Disease Activity in Patients with Inflammatory Bowel Disease

Journal of Clinical Medicine ◽

10.3390/jcm8091319 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1319 ◽

Cited By ~ 6

Author(s):

Hausmann ◽

Kubesch ◽

Amiri ◽

Filmann ◽

Blumenstein

Keyword(s):

Inflammatory Bowel Disease ◽

Vitamin D ◽

Serum Concentration ◽

Disease Activity ◽

Vitamin D Deficiency ◽

Bowel Disease ◽

Chronic Inflammatory Bowel Disease ◽

Close Monitoring ◽

Vitamin D Levels ◽

Inflammatory Bowel

Background and Aims: Vitamin D has an inhibitory role in the inflammatory signaling pathways and supports the integrity of the intestinal barrier. Due to its immunomodulatory effect, vitamin D plays a role in chronic inflammatory bowel disease (IBD) and a deficiency is associated with an increased risk for a flare. We aimed to investigate to what extent the 25-hydroxyvitamin D (25(OH)D3) level correlates with disease activity and whether a cut-off value can be defined that discriminates between active disease and remission. Methods: Patients with IBD, treated at the University Hospital Frankfurt were analyzed retrospectively. The 25(OH)D3 levels were correlated with clinical activity indices and laboratory chemical activity parameters. A deficiency was defined as 25(OH)D3 levels <30 ng/mL. Results: A total of 470 (257 female) patients with IBD were included, 272 (57.9%) with Crohn’s disease (CD), 198 (42.1%) with ulcerative colitis (UC). The median age of the patients was 41 (18–84). In 283 patients (60.2%), a vitamin D deficiency was detected. 245 (53.6%) patients received oral vitamin D supplementation, and supplemented patients had significantly higher vitamin D levels (p < 0.0001). Remission, vitamin D substitution, and male gender were independently associated with the 25(OH)D3 serum concentration in our cohort in regression analysis. A 25(OH)D3 serum concentration of 27.5 ng/mL was the optimal cut-off value. Conclusion: Vitamin D deficiency is common in IBD patients and appears to be associated with increased disease activity. In our study, vitamin D levels were inversely associated with disease activity. Thus, close monitoring should be established, and optimized supplementation should take place.

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