title: Association of Vitamin D Level With Clinical Status in Inflammatory Bowel Disease: A 5-Year Longitudinal Study.
abstract: Emerging data suggest that vitamin D has a significant role in inflammatory bowel disease (IBD). Prospective data evaluating the association of vitamin D serum status and disease course are lacking. We sought to determine the relationship between vitamin D status and clinical course of IBD over a multiyear time period.
  
  
  
  IBD patients with up to 5-year follow-up from a longitudinal IBD natural history registry were included. Patients were categorized according to their mean serum 25-OH vitamin D level. IBD clinical status was approximated with patterns of medication use, health-care utilization, biochemical markers of inflammation (C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)), pain and clinical disease activity scores, and health-related quality of life.
  
  
  
  A total of 965 IBD patients (61.9% Crohn's disease, 38.1% ulcerative colitis) formed the study population (mean age 44 years, 52.3% female). Among them, 29.9% had low mean vitamin D levels. Over the 5-year study period, subjects with low mean vitamin D required significantly more steroids, biologics, narcotics, computed tomography scans, emergency department visits, hospital admissions, and surgery compared with subjects with normal mean vitamin D levels (P<0.05). Moreover, subjects with low vitamin D levels had worse pain, disease activity scores, and quality of life (P<0.05). Finally, subjects who received vitamin D supplements had a significant reduction in their health-care utilization.
  
  
  
  Low vitamin D levels are common in IBD patients and are associated with higher morbidity and disease severity, signifying the potential importance of vitamin D monitoring and treatment.
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Toufic A
authors.initials: TA
authors.lastname: Kabbani
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Ioannis E
authors.initials: IE
authors.lastname: Koutroubakis
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Schoen
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Claudia
authors.initials: C
authors.lastname: Ramos-Rivers
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Shah
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Swoger
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Miguel
authors.initials: M
authors.lastname: Regueiro
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Arthur
authors.initials: A
authors.lastname: Barrie
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Marc
authors.initials: M
authors.lastname: Schwartz
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Jana G
authors.initials: JG
authors.lastname: Hashash
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Leonard
authors.initials: L
authors.lastname: Baidoo
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Dunn
authors.affiliation: Department of Medicine and Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Binion
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000097:blood*; D003424:Crohn Disease / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors; D014807:Vitamin D / Q000097:blood*
chemical_list: D014807:Vitamin D