American Journal of Clinical Medicine Research
ISSN (Print): 2328-4005 ISSN (Online): 2328-403X Website: http://www.sciepub.com/journal/ajcmr Editor-in-chief: Dario Galante
Open Access
Journal Browser
Go
American Journal of Clinical Medicine Research. 2021, 9(1), 19-24
DOI: 10.12691/ajcmr-9-1-5
Open AccessArticle

Vitamin D deficiency and Risk Factors in Patients with Crohn’s Disease

Wei-Juan Song1 and Rui-Xia Yang1,

1Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

Pub. Date: February 01, 2021

Cite this paper:
Wei-Juan Song and Rui-Xia Yang. Vitamin D deficiency and Risk Factors in Patients with Crohn’s Disease. American Journal of Clinical Medicine Research. 2021; 9(1):19-24. doi: 10.12691/ajcmr-9-1-5

Abstract

Background: To explore vitamin D(VD) levels in patients with Crohn's disease, and the correlation between VD levels and seasons, disease activity, lesion region, hormone therapy. To find the risk factors of VD deficiency and the role of VD in the pathogenesis and treatment of Crohn’s disease. Methods: Between March 2018 and December 2019, 86 patients diagnosed with CD at the First Affiliated Hospital of Nanjing Medical University were identified, and 86 healthy people were selected as the control group at the same time. VD, counts of white blood cells (WBC), hemoglobin (Hb), counts of platelet(PLT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin (ALB) levels were recorded at the same time of colonoscopy. Logistic regression analysis of the relationship between disease activity, lesion region, hormone therapy and vitamin D deficiency in patients with Crohn's disease, and analyze possible risk factors. Results: The levels of VD in patients with CD was significantly lower than that in the healthy controls (35.10 nmol/L vs 67.60 nmol/L), the difference was statistically significant (Z= -10.527, P<0.001). The summer autumn group was significantly higher than the winter spring group (z = -2.215, P = 0. 027). Patients with ileum lesions have a higher proportion of vitamin D deficiency than patients with non-ileum lesions. vitamin D deficiency rate of patients in activity stage is higher than that of patients in remission stage. With the increase of the degree of inflammation, the level of vitamin D decreased. Logistic regression analysis shows that platelet count > 250 × 109 /L, CRP ≥ 8 mg / L, ALB < 30 g/L and hormone therapy were risk factors for vitamin D deficiency(P<0.05). Conclusions: Patients with CD have low levels of VD, which is related to seasons. platelet count > 250 × 109 /L, CRP ≥ 8 mg / L, ALB < 30 g/L, and hormone therapy were risk factors for V D deficiency in patient with CD.

Keywords:
Vitamin D deficiency risk factors Crohn's disease

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Hanauer SB. Inflammatory bowel disease: epidemiology, pathogenesis, and therapeutic opportunities. Inflamm Bowel Dis 2006; 12 Suppl 1: S3-9.
 
[2]  Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L.Crohn’s disease. Lancet 2017; 389: 1741-1755.
 
[3]  Veauthier B,Hornecker JR.Crohn's Disease: Diagnosis and Management. Am Fam Physician 2018; 98: 661-669.
 
[4]  Ballester Ferré MP, Boscá-Watts MM,Mínguez Pérez M.Crohn's disease. Med Clin (Barc) 2018; 151: 26-33.
 
[5]  Molodecky NA,Soon IS,Rabi DM,Ghali WA,Ferris M,Chernoff G, et al.Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 2012; 142: 46-54.e42; quiz e30.
 
[6]  Gubatan J,Moss AC.Vitamin D in inflammatory bowel disease: more than just a supplement. Curr Opin Gastroenterol 2018; 34: 217-225.
 
[7]  Schäffler H, Schmidt M, Huth A, Reiner J, Glass Ä,Lamprecht G. Clinical factors are associated with vitamin D levels in IBD patients: A retrospective analysis. J Dig Dis 2018; 19: 24-32.
 
[8]  White JH.Vitamin D deficiency and the pathogenesis of Crohn's disease. J Steroid Biochem Mol Biol 2018; 175: 23-28.
 
[9]  Fletcher J, Cooper SC, Ghosh S,Hewison M.The Role of Vitamin D in Inflammatory Bowel Disease: Mechanism to Management. Nutrients 2019; 11.
 
[10]  Ananthakrishnan AN,Khalili H,Higuchi LM,Bao Y,Korzenik JR,Giovannucci EL, et al.Higher predicted vitamin D status is associated with reduced risk of Crohn's disease. Gastroenterology 2012; 142: 482-9.
 
[11]  Palmer MT,Weaver CT.Linking vitamin d deficiency to inflammatory bowel disease. Inflamm Bowel Dis 2013; 19: 2245-56.
 
[12]  Cantorna MT, Munsick C, Bemiss C,Mahon BD. 1,25-Dihydroxycholecalciferol prevents and ameliorates symptoms of experimental murine inflammatory bowel disease. J Nutr 2000; 130: 2648-52.
 
[13]  Froicu M, Zhu Y,Cantorna MT.Vitamin D receptor is required to control gastrointestinal immunity in IL-10 knockout mice. Immunology 2006; 117: 310-8.
 
[14]  Lagishetty V, Misharin AV, Liu NQ, Lisse TS, Chun RF, Ouyang Y, et al. Vitamin D deficiency in mice impairs colonic antibacterial activity and predisposes to colitis. Endocrinology 2010; 151: 2423-32.
 
[15]  Slama IB, Allali F, Lakhdar T, El Kabbaj S, Medrare L, Ngeuleu A, et al. Reliability and validity of CDAI and SDAI indices in comparison to DAS-28 index in Moroccan patients with rheumatoid arthritis. BMC Musculoskelet Disord 2015; 16: 268.
 
[16]  Mary JY, Modigliani R. Development and validation of an endoscopic index of the severity for Crohn's disease: a prospective multicentre study. Groupe d'Etudes Thérapeutiques des Affections Inflammatoires du Tube Digestif (GETAID). Gut 1989; 30: 983-9.
 
[17]  Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911-30.
 
[18]  Ham NS, Hwang SW, Oh EH, Kim J, Lee HS, Park SH, et al. Influence of Severe Vitamin D Deficiency on the Clinical Course of Inflammatory Bowel Disease. Dig Dis Sci 2020;
 
[19]  Tan B, Li P, Lv H, Li Y, Wang O, Xing XP, et al. Vitamin D levels and bone metabolism in Chinese adult patients with inflammatory bowel disease. J Dig Dis 2014; 15: 116-23.
 
[20]  Zerofsky M, Ryder M, Bhatia S, Stephensen CB, King J, Fung EB. Effects of early vitamin D deficiency rickets on bone and dental health, growth and immunity. Matern Child Nutr 2016; 12: 898-907.
 
[21]  Carlberg C. Endocrine functions of vitamin D. Mol Cell Endocrinol 2017; 453: 1-2.
 
[22]  Amling M, Barvencik F.[Calcium and vitamin D in osteology]. Z Rheumatol 2015; 74: 421-32; quiz 433-4.
 
[23]  Sawatsubashi S.[Bone and Nutrition. The vitamin D functions in osteoblasts and osteocytes]. Clin Calcium 2015; 25: 991-7.
 
[24]  Isenring EA, Teleni L, Woodman RJ, Kimlin MG, Walpole E, Karapetis CS, et al.Serum vitamin D decreases during chemotherapy: an Australian prospective cohort study. Asia Pac J Clin Nutr 2018; 27: 962-967.
 
[25]  Nelson CD, Powell JL, Price DM, Hersom MJ, Yelich JV, Drewnoski ME, et al. Assessment of serum 25-hydroxyvitamin D concentrations of beef cows and calves across seasons and geographical locations. J Anim Sci 2016; 94: 3958-3965.
 
[26]  Farrokhyar F, Tabasinejad R, Dao D, Peterson D, Ayeni OR, Hadioonzadeh R, et al. Prevalence of vitamin D inadequacy in athletes: a systematic-review and meta-analysis. Sports Med 2015; 45: 365-78.