Acta clinica Croatica, Vol. 59. No. 1., 2020.
Original scientific paper
https://doi.org/10.20471/acc.2020.59.01.13
High Prevalence of Untreated and Undertreated Vitamin D Deficiency and Insufficiency in Patients with Inflammatory Bowel Disease
Viktor Domislović
orcid.org/0000-0002-3715-5730
; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
Darija Vranešić Bender
; Unit of Clinical Nutrition, Zagreb University Hospital Centre, Zagreb, Croatia; Faculty of Food Technology and Biotechnology, University of Zagreb, Zagreb, Croatia
Ana Barišić
; Unit of Clinical Nutrition, Zagreb University Hospital Centre, Zagreb, Croatia
Marko Brinar
; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Dina Ljubas Kelečić
; Unit of Clinical Nutrition, Zagreb University Hospital Centre, Zagreb, Croatia
Cecilija Rotim
; Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia
Martin Novosel
orcid.org/0000-0003-4379-6128
; School of Medicine, University of Zagreb, Zagreb, Croatia
Marija Matašin
; School of Medicine, University of Zagreb, Zagreb, Croatia
Željko Krznarić
; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia; Unit of Clinical Nutrition, Zagreb University Hospital Centre, Zagreb, Croatia; School of Medicine, University of Zagreb, Zagreb, Croatia
Abstract
Inflammatory bowel disease (IBD) patients with vitamin D deficiency show an increased risk of hospital admission, surgery, and loss of response to biologic therapy while high vitamin D levels are identified as a protective factor. Our goal was to investigate the prevalence of untreated and undertreated vitamin D deficiency and factors associated with vitamin D deficiency. In this cross-sectional study, we measured serum vitamin D in a random sample of Caucasian IBD patients. Vitamin D deficiency was defined as <50 nmol/L and insufficiency as 50-75 nmol/L. Supplementation was defined as taking 800-2000 IU vitamin D daily. Untreated patients were defined as not taking supplementation and undertreated group as receiving supplementation but showing vitamin D deficiency or insufficiency despite treatment. Our study included 185 IBD patients, i.e. 126 (68.1%) with Crohn’s disease (CD) and 59 (31.9%) with ulcerative colitis (UC). Overall, 108 (58.4%) patients had vitamin D deficiency and 60 (32.4%) patients vitamin D insufficiency. There were 16 (14.8%) and 11 (18.3%) treated patients in vitamin D deficiency and vitamin D insufficiency group, respectively.
The rate of untreated patients was 81.7% (n=49) in vitamin D deficiency group and 85.2% (n=92) in vitamin D insufficiency group. Tumor necrosis factor alpha inhibitors were associated with higher
serum vitamin D levels in CD and UC, and ileal involvement, ileal and ileocolonic resection with lower levels. In conclusion, not only is vitamin D deficiency common in IBD patients but the proportion of untreated and undertreated patients is considerably high. We suggest regular monitoring of vitamin D levels in IBD patients regardless of receiving vitamin D supplementation therapy.
Keywords
Inflammatory bowel diseases; Vitamin D deficiency; Crohn’s disease; Colitis, ulcerative
Hrčak ID:
242290
URI
Publication date:
1.3.2020.
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