Vitamin D deficiency in Crohn's disease: prevalence, risk factors and supplement use in an outpatient setting.
OBJECTIVE
Vitamin D deficiency impacts on bone health and has potential new roles in inflammation. We aimed to determine the prevalence of and risk factors for vitamin D deficiency and to explore vitamin D supplement usage in patients with Crohn's disease (CD) in an outpatient setting, compared with controls.


METHODS
Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured by radioimmunoassay in 151 participants, comprising 81 CD patients and 70 age-, sex- and socio-economic status-matched healthy controls. Levels of 25(OH)D <50 nmol/L were classed as deficient. Data on vitamin supplement usage were recorded for all participants at interview.


RESULTS
Vitamin D deficiency was common in patients with CD (63%) and significantly higher in winter than summer (68% v 50%; p<0.001, χ(2)). Notably, the deficiency rate remained high even in summer (50%). On regression analysis, 25(OH)D levels were inversely associated with winter season. Disease-specific factors for lower serum 25(OH)D levels were longer disease duration and smoking. Overall, 43% of patients reported using a vitamin D-containing supplement, primarily at low dosages (200-400 IU/d); however, this level of supplement did not prevent deficiency. For the majority of CD patients, 25(OH)D remained below optimal levels proposed to confer bone and immune health benefits.


CONCLUSIONS
Vitamin D deficiency was common in patients with CD and associated with longstanding disease, smoking and winter. While over 40% of patients used a vitamin D-containing supplement, the dosages were inadequate to prevent deficiency. Appropriate vitamin D screening and supplementation should be considered in the context of health promotion of outpatients with CD.
Department of Clinical Medicine, Trinity College Dublin, Adelaide & Meath Hospital, Dublin, Ireland.
Treasa Nic
TN
Suibhne
Gerry
G
Cox
Martin
M
Healy
Colm
C
O'Morain
Maria
M
O'Sullivan
D000328:Adult; D000553:Ambulatory Care; D003424:Crohn Disease / Q000097:blood / Q000150:complications*; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012621:Seasons; D012907:Smoking / Q000009:adverse effects; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D014815:Vitamins / Q000627:therapeutic use*
D014815:Vitamins; D014807:Vitamin D; C104450:25-hydroxyvitamin D