BACKGROUND: Vitamin D may have an immunologic role in Crohn's disease (CD) and ulcerative colitis (UC). Retrospective studies suggested a weak association between vitamin D status and disease activity but have significant limitations. METHODS: Using a multi-institution inflammatory bowel disease cohort, we identified all patients with CD and UC who had at least one measured plasma 25-hydroxy vitamin D (25(OH)D). Plasma 25(OH)D was considered sufficient at levels ≥30 ng/mL. Logistic regression models adjusting for potential confounders were used to identify impact of measured plasma 25(OH)D on subsequent risk of inflammatory bowel disease-related surgery or hospitalization. In a subset of patients where multiple measures of 25(OH)D were available, we examined impact of normalization of vitamin D status on study outcomes. RESULTS: Our study included 3217 patients (55% CD; mean age, 49 yr). The median lowest plasma 25(OH)D was 26 ng/mL (interquartile range, 17-35 ng/mL). In CD, on multivariable analysis, plasma 25(OH)D <20 ng/mL was associated with an increased risk of surgery (odds ratio, 1.76; 95% confidence interval, 1.24-2.51) and inflammatory bowel disease-related hospitalization (odds ratio, 2.07; 95% confidence interval, 1.59-2.68) compared with those with 25(OH)D ≥30 ng/mL. Similar estimates were also seen for UC. Furthermore, patients with CD who had initial levels <30 ng/mL but subsequently normalized their 25(OH)D had a reduced likelihood of surgery (odds ratio, 0.56; 95% confidence interval, 0.32-0.98) compared with those who remained deficient. CONCLUSION: Low plasma 25(OH)D is associated with increased risk of surgery and hospitalizations in both CD and UC, and normalization of 25(OH)D status is associated with a reduction in the risk of CD-related surgery.
BACKGROUND:Vitamin D may have an immunologic role in Crohn's disease (CD) and ulcerative colitis (UC). Retrospective studies suggested a weak association between vitamin D status and disease activity but have significant limitations. METHODS: Using a multi-institution inflammatory bowel disease cohort, we identified all patients with CD and UC who had at least one measured plasma 25-hydroxy vitamin D (25(OH)D). Plasma 25(OH)D was considered sufficient at levels ≥30 ng/mL. Logistic regression models adjusting for potential confounders were used to identify impact of measured plasma 25(OH)D on subsequent risk of inflammatory bowel disease-related surgery or hospitalization. In a subset of patients where multiple measures of 25(OH)D were available, we examined impact of normalization of vitamin D status on study outcomes. RESULTS: Our study included 3217 patients (55% CD; mean age, 49 yr). The median lowest plasma 25(OH)D was 26 ng/mL (interquartile range, 17-35 ng/mL). In CD, on multivariable analysis, plasma 25(OH)D <20 ng/mL was associated with an increased risk of surgery (odds ratio, 1.76; 95% confidence interval, 1.24-2.51) and inflammatory bowel disease-related hospitalization (odds ratio, 2.07; 95% confidence interval, 1.59-2.68) compared with those with 25(OH)D ≥30 ng/mL. Similar estimates were also seen for UC. Furthermore, patients with CD who had initial levels <30 ng/mL but subsequently normalized their 25(OH)D had a reduced likelihood of surgery (odds ratio, 0.56; 95% confidence interval, 0.32-0.98) compared with those who remained deficient. CONCLUSION: Low plasma 25(OH)D is associated with increased risk of surgery and hospitalizations in both CD and UC, and normalization of 25(OH)D status is associated with a reduction in the risk of CD-related surgery.
Authors: Ashwin N Ananthakrishnan; Hamed Khalili; Leslie M Higuchi; Ying Bao; Joshua R Korzenik; Edward L Giovannucci; James M Richter; Charles S Fuchs; Andrew T Chan Journal: Gastroenterology Date: 2011-12-09 Impact factor: 22.682
Authors: Alex Ulitsky; Ashwin N Ananthakrishnan; Amar Naik; Sue Skaros; Yelena Zadvornova; David G Binion; Mazen Issa Journal: JPEN J Parenter Enteral Nutr Date: 2011-05 Impact factor: 4.016
Authors: Gauree Gupta Konijeti; Pankaj Arora; Matthew R Boylan; Yanna Song; Shi Huang; Frank Harrell; Christopher Newton-Cheh; Dillon O'Neill; Joshua Korzenik; Thomas J Wang; Andrew T Chan Journal: J Clin Endocrinol Metab Date: 2015-12-14 Impact factor: 5.958
Authors: Ashwin N Ananthakrishnan; Andrew Cagan; Vivian S Gainer; Su-Chun Cheng; Tianxi Cai; Peter Szolovits; Stanley Y Shaw; Susanne Churchill; Elizabeth W Karlson; Shawn N Murphy; Isaac Kohane; Katherine P Liao Journal: J Crohns Colitis Date: 2014-02-19 Impact factor: 9.071
Authors: Toufic A Kabbani; Ioannis E Koutroubakis; Robert E Schoen; Claudia Ramos-Rivers; Nilesh Shah; Jason Swoger; Miguel Regueiro; Arthur Barrie; Marc Schwartz; Jana G Hashash; Leonard Baidoo; Michael A Dunn; David G Binion Journal: Am J Gastroenterol Date: 2016-03-08 Impact factor: 10.864