Vitamin D Deficiency Increases With Severity of Inflammatory Bowel Disease

Study finds few patients were adherent to supplements.

Inflammatory bowel disease patients were found to be deficient of vitamin D and despite improved results with supplementation, adherence was poor, according to a recent study.

The study enrolled 137 patients at baseline, including 95 patients with Crohn's disease and 42 with ulcerative colitis, however, only 131 patients had contemporaneous vitamin D levels required for participation. The patients, who were aged between 18 and 50 years, were observed for a period of 12 months between 2012 and 2014.

In patients with active disease, 35% had deficient vitamin D levels, while 65% had sufficient vitamin D levels. In those with mild disease, only 23% had deficient vitamin D and 77% had sufficient vitamin D.

At baseline, 38% of patients had either osteopenia or osteoporosis. Osteopenia and osteoporosis occurred in 26 patients despite vitamin D deficiency, while mean vitamin D did not differ among patients with normal versus abnormal bone mineral density (65 nmol/L vs 68 nmol/L).

After 12-months, 29% of patients had low vitamin D, of which 58% were deficient at baseline.

Just 10 of 30 patients who were advised to use vitamin D supplements reported adherence, with 8 of those 10 achieving sufficient vitamin D levels. Meanwhile, 13 of the remaining 20 patients advised to take supplements remained deficient, and 7 achieved sufficient vitamin D levels without supplementation.

None of the patients advised to take supplements had significant changes in their IBD questionnaire scores.

“Despite advice, vitamin D therapy was poorly adopted, but biochemically successful when taken,” the study authors wrote. “As yet, the relationships among disease activity, quality of life, and vitamin D and the role of supplementation are unclear; however, for prevention of future osteoporosis alone, it may be justified given the prevalence of deficiency we have discovered.”