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Journal of Crohn's and Colitis: 9 (4)

Editor-in-Chief

Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium

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Vitamin D deficiency in Crohn's disease and healthy controls: A prospective case–control study in the Netherlands

Jessica R. de Bruyn , Rosanne van Heeckeren , Cyriel Y. Ponsioen , Gijs R. van den Brink , Mark Löwenberg , Albert J. Bredenoord , Gerard Frijstein , Geert R. D’Haens
DOI: http://dx.doi.org/10.1016/j.crohns.2014.03.004 1267-1273 First published online: 1 October 2014

Abstract

Background and aims: Vitamin D deficiency has been observed in a wide range of medical conditions including Crohn's disease (CD). We aimed to assess whether CD patients have lower vitamin D levels than healthy controls, and to determine risk factors for vitamin D deficiency. Methods: 25(OH)D was measured by chemiluminescent immunoassay in serum obtained from 101 CD patients and 41 controls. Demographics, sunlight exposure, dietary vitamin D intake, comorbidities and medication were recorded using validated questionnaires. In CD patients the Harvey–Bradshaw index, Montreal classification and surgical resections were also evaluated. 25(OH)D levels of >75 nmol/L, between 50 and 75 nmol/L and <50 nmol/L were considered as normal, suboptimal and deficient, respectively.

Results: Vitamin D levels were rather low but comparable among CD patients and controls (mean 25(OH)D 51.6 nmol/L(±26.6) in CD, and 60.8 nmol/L(±27.6) in controls. Multivariate regression analysis revealed BMI, sun protection behaviour, non-Caucasian ethnicity, no use of tanning beds, and no holidays in the last year as significantly associated with serum 25(OH)D levels in CD patients (R = 0.62). In the control group no statistically significant factors were identified that had an impact on 25(OH)D serum levels.

Conclusions: Vitamin D deficiency is common in CD patients, but also in healthy controls. Appropriate vitamin D screening should be advised in patients with CD. Moreover, the positive effect of sunlight on the vitamin D status should be discussed with CD patients, but this should be balanced against the potential risk of developing melanomas, especially in patients using thiopurines.

Key words
  • Inflammatory bowel disease
  • Crohn's disease
  • Vitamin D
  • 25(OH)D
  • Abbreviations:
    CD
    Crohn's disease
    25(OH)D
    25-hydroxyvitamin D
    1,25(OH)2D
    1.25-dihydroxyvitamin D
    PTH
    parathyroid hormone
    UV
    ultraviolet
    HBI
    Harvey-Bradshaw Index
    CRP
    C-reactive protein
    IQR
    interquartile range
    MS
    multiple sclerosis
    IL
    interleukin
    LC-MS/MS
    liquid chromatography-tandem mass spectometry
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