Vitamin D status in relation to Crohn’s disease: meta-analysis of observational studies
Nutrition DOI: http://dx.doi.org/10.1016/j.nut.2015.11.008
Mehdi Sadeghian, Parvane Saneei, Fereydoun Siassi, Ahmad Esmaillzadeh
Study Highlights
- Growing evidence suggests a relationship between vitamin D status and the progression of Crohn’s disease.
- Vitamin D status in Crohn’s disease compared with healthy controls
has inconsistent results in deficiency and correlations with disease activity. - Summarizing earlier evidence on the association of vitamin D status and Crohn’s disease,
this meta-analysis revealed that CD patients had lower mean levels of 25(OH)D compared with healthy controls. - A significant correlation was seen between latitude and 25(OH)D levels.
More than half of the patients with CD had vitamin D deficiency. - Individuals with lower concentrations of 25(OH)D had greater disease activity than those with sufficient concentrations.
Is vitamin D supplementation a viable treatment for Crohn's disease – Nov 2015
Crohn's disease associated with 7.6X deactivation of Vitamin D receptor – July 2015
Gut microbiome massively changed by high dose vitamin D – July 2015
Crohn's disease treated by 2000 IU Vitamin D - RCT June 2015
IBD (Collitis, Crohn’s) was active 6X more often if low vitamin D – June 2015
Boron and Granulomas (TB, Rheumatoid arthritis, Crohn's, Rheumatic Fever etc.) - 2015
Crohn’s disease helped when vitamin D level raised above 30 ng – RCT Feb 2015
Latitude
See also web
NCT02208310 - Trial of High Dose Vitamin D in Patient's With Crohn's Disease
10,000 IU vs 400 IU RCT, completed April 2016, not aware of any publication as of Dec 2016
Background and Aims
Inconsistent findings were published regarding vitamin D status among patients with Crohn’s Disease (CD) and the association with disease severity. We aimed to perform a meta-analysis evaluating serum 25-hydroxyvitamin D and 1,25dehydroxyvitamin D among CD patients compared with healthy and non-healthy controls and the prevalence of vitamin D deficiency as well as the association with disease activity.
Methods
We searched MEDLINE, SCOPUS, EMBASE and Google Scholar up to March 2015 for observational studies assessed serum vitamin D levels in CD patients. A total of 63 studies were included in the following four meta-analyses:
- 1) a meta-analysis on the mean difference of 25(OH)D levels in CD patients compared with healthy (number of studies=27) and non-healthy (n=25) controls;
- 2) a meta-analysis on the mean difference of 1,25(OH)2D3 levels in CD patients compared with healthy (n=7) and non-healthy (n=8) controls;
- 3) a meta-analysis on the prevalence of vitamin D deficiency (n=34);
- 4) a meta-analysis on the correlation coefficients between vitamin D status severity of CD (n=6).
Subgroup analysis and meta-regression were used to discover possible sources of between-study heterogeneity.
Results
It was found that CD patients had lower levels of 25(OH)D compared with healthy (-3.99 ng/mL; 95% Confidence Interval CI: -5.91 to -2.08) but not non-healthy controls (-1.07 ng/mL; 95% CI: -2.84 to 0.70). There was also no significant mean difference for 1,25(OH)2D3 for both healthy and non-healthy controls. Meta-analysis on the prevalence of vitamin D deficiency showed an overall prevalence of 57.7% (95% CI: 0.502 to 0.649). An inverse association was observed between serum vitamin D and severity of CD (-0.36; 95% CI: -0.48 to -0.24). Meta-regression showed that mean levels of 25(OH)D was decreased 0.09 for each unit change of latitude among CD patients compared with healthy controls (B=-0.09, P=0.004, I2residual=86.08%).
Conclusion
we found that patients with Crohn’s disease had lower serum 25(OH)D concentrations compared with their healthy counterparts and more than half of them have hypovitaminosis D. Moreover, there was an inverse correlation between circulating 25(OH)D concentrations and severity of Crohn’s disease.