Background:
Vitamin D has an immunoregulatory action in Inflammatory Bowel Disease (IBD) as well
as other immune-mediated disorders. Its influence on intestinal permeability, innate and adaptive immunity, and the
composition and diversity of the microbiota contribute to the maintenance of intestinal homeostasis. Patients with
IBD have a greater prevalence of vitamin D deficiency than the general population, and a possible association between
this deficit and a worse course of the disease. However, intervention studies in patients with IBD have proved
inconclusive.
Objective:
To review all the evidence concerning the role of vitamin D as an important factor in the pathophysiology
of IBD, review the associations found between its deficiency and the prognosis of the disease, and draw conclusions
for the practical application from the main intervention studies undertaken.
Method:
Structured search and review of basic, epidemiological, clinical and intervention studies evaluating the
influence of vitamin D in IBD, following the basic principles of scientific data.
Results:
Vitamin D deficiency is associated with disease activity, quality of life, the consumption of social and
healthcare resources, and the durability of anti-TNFα biological treatment. Determination of new metabolites of
vitamin D, measurement of its absorption capacity and questionnaires about sun exposure could help identify groups
of IBD patients with a special risk of vitamin D deficiency.
Conclusion:
Well-designed intervention studies are needed in IBD, with probably higher objective plasma doses of
vitamin D to establish its efficacy as a therapeutic agent with immunomodulatory properties. Meanwhile, vitamin D
deficiency should be screened for and corrected in affected patients in order to achieve adequate bone and phosphocalcic
metabolism.
Low Sun Exposure and Vitamin D Deficiency as Risk Factors for Inflammatory Bowel Disease, With a Focus on Childhood Onset
