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Review article: vitamin D and inflammatory bowel diseases
Author(s) -
Mouli V. P.,
Ananthakrishnan A. N.
Publication year - 2014
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12553
Subject(s) - medicine , inflammatory bowel disease , vitamin d and neurology , ulcerative colitis , vitamin d deficiency , gastroenterology , vitamin , crohn's disease , cohort , colitis , placebo , disease , immunology , pathology , alternative medicine
Summary Background Vitamin D is traditionally associated with bone metabolism. The immunological effects of vitamin D have increasingly come into focus. Aim To review the evidence supporting a role of vitamin D in inflammatory bowel diseases. Methods A comprehensive search was performed on PubMed using the terms ‘crohn's disease’ ‘ulcerative colitis’ and ‘vitamin D’. Results Vitamin D deficiency is common in patients with inflammatory bowel diseases (IBD) (16–95%) including those with recently diagnosed disease. Evidence supports immunological role of vitamin D in IBD. In animal models, deficiency of vitamin D increases susceptibility to dextran sodium sulphate colitis, while 1,25(OH) 2 D 3 ameliorates such colitis. One prospective cohort study found low predicted vitamin D levels to be associated with an increased risk of Crohn's disease (CD). Limited data also suggest an association between low vitamin D levels and increased disease activity, particularly in CD. In a large cohort, vitamin D deficiency (<20 ng/mL) was associated with increased risk of surgery (OR 1.8, 95% CI 1.2–2.5) in CD and hospitalisations in both CD (OR 2.1, 95% CI 1.6–2.7) and UC (OR 2.3, 95% CI 1.7–3.1). A single randomised controlled trial demonstrated that vitamin D supplementation may be associated with reduced frequency of relapses in patients with CD compared with placebo (13% vs. 29%, P = 0.06). Conclusions There is growing epidemiological evidence to suggest a role for vitamin D deficiency in the development of IBD and also its influence on disease severity. The possible therapeutic role of vitamin D in patients with IBD merits continued investigation.