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Journal of Crohn's and Colitis: 9 (8)

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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