BACKGROUND: Patients with inflammatory bowel diseases (IBD) have an increased risk of clostridium difficile infection (CDI). Cathelicidins are anti-microbial peptides that attenuate colitis and inhibit the effect of clostridial toxins. Plasma calcifediol [25(OH)D] stimulates production of cathelicidins. AIM: To examine the association between plasma 25(OH)D and CDI in patients with IBD. METHODS: From a multi-institutional IBD cohort, we identified patients with at least one measured plasma 25(OH)D. Our primary outcome was development of CDI. Multivariate logistic regression models adjusting for potential confounders were used to identify independent effect of plasma 25(OH)D on risk of CDI. RESULTS: We studied 3188 IBD patients of whom 35 patients developed CDI. Patients with CDI-IBD were older and had greater co-morbidity. The mean plasma 25(OH)D level was significantly lower in patients who developed CDI (20.4 ng/mL) compared to non-CDI-IBD patients (27.1 ng/mL) (P = 0.002). On multivariate analysis, each 1 ng/mL increase in plasma 25(OH)D was associated with a 4% reduction in risk of CDI (OR 0.96, 95% CI 0.93-0.99, P = 0.046). Compared to individuals with vitamin D >20 ng/mL, patients with levels <20 ng/mL were more likely to develop CDI (OR 2.27, 95% CI 1.16-4.44). The mean plasma 25(OH)D in patients with CDI who subsequently died was significantly lower (12.8 ± 8.1 ng/mL) compared to those who were alive at the end of follow-up (24.3 ± 13.2 ng/mL) (P = 0.01). CONCLUSIONS: Higher plasma calcifediol [25(OH)D] is associated with reduced risk of C. difficile infection in patients with IBD. Further studies of therapeutic supplementation of vitamin D in patients with inflammatory bowel disease and C. difficile infection may be warranted.
BACKGROUND:Patients with inflammatory bowel diseases (IBD) have an increased risk of clostridium difficileinfection (CDI). Cathelicidins are anti-microbial peptides that attenuate colitis and inhibit the effect of clostridial toxins. Plasma calcifediol [25(OH)D] stimulates production of cathelicidins. AIM: To examine the association between plasma 25(OH)D and CDI in patients with IBD. METHODS: From a multi-institutional IBD cohort, we identified patients with at least one measured plasma 25(OH)D. Our primary outcome was development of CDI. Multivariate logistic regression models adjusting for potential confounders were used to identify independent effect of plasma 25(OH)D on risk of CDI. RESULTS: We studied 3188 IBD patients of whom 35 patients developed CDI. Patients with CDI-IBD were older and had greater co-morbidity. The mean plasma 25(OH)D level was significantly lower in patients who developed CDI (20.4 ng/mL) compared to non-CDI-IBD patients (27.1 ng/mL) (P = 0.002). On multivariate analysis, each 1 ng/mL increase in plasma 25(OH)D was associated with a 4% reduction in risk of CDI (OR 0.96, 95% CI 0.93-0.99, P = 0.046). Compared to individuals with vitamin D >20 ng/mL, patients with levels <20 ng/mL were more likely to develop CDI (OR 2.27, 95% CI 1.16-4.44). The mean plasma 25(OH)D in patients with CDI who subsequently died was significantly lower (12.8 ± 8.1 ng/mL) compared to those who were alive at the end of follow-up (24.3 ± 13.2 ng/mL) (P = 0.01). CONCLUSIONS: Higher plasma calcifediol [25(OH)D] is associated with reduced risk of C. difficileinfection in patients with IBD. Further studies of therapeutic supplementation of vitamin D in patients with inflammatory bowel disease and C. difficileinfection may be warranted.
Authors: Ashwin N Ananthakrishnan; Tianxi Cai; Guergana Savova; Su-Chun Cheng; Pei Chen; Raul Guzman Perez; Vivian S Gainer; Shawn N Murphy; Peter Szolovits; Zongqi Xia; Stanley Shaw; Susanne Churchill; Elizabeth W Karlson; Isaac Kohane; Robert M Plenge; Katherine P Liao Journal: Inflamm Bowel Dis Date: 2013-06 Impact factor: 5.325
Authors: Tressia C Hing; Samantha Ho; David Q Shih; Ryan Ichikawa; Michelle Cheng; Jeremy Chen; Xinhua Chen; Ivy Law; Robert Najarian; Ciaran P Kelly; Richard L Gallo; Stephan R Targan; Charalabos Pothoulakis; Hon Wai Koon Journal: Gut Date: 2012-07-03 Impact factor: 23.059
Authors: Alyce Anderson; Benjamin Click; Claudia Ramos-Rivers; Debbie Cheng; Dmitriy Babichenko; Ioannis E Koutroubakis; Jana G Hashash; Marc Schwartz; Jason Swoger; Arthur M Barrie; Michael A Dunn; Miguel Regueiro; David G Binion Journal: Inflamm Bowel Dis Date: 2017-12 Impact factor: 5.325
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