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Vitamin D deficiency in a European inflammatory bowel disease inception cohort

an Epi-IBD study

Chetcuti Zammit, Stefaniaa; Ellul, Pierrea; Girardin, Giuliad; Valpiani, Danielae; Nielsen, Kári R.f; Olsen, Jóngerðf; Goldis, Adriang; Lazar, Danielag; Shonová, Olgah; Nováková, Marieh; Sebastian, Shajib; Whitehead, Emmab; Carmona, Amaliaj; Martinez-Cadilla, Jesusk; Dahlerup, Jens F.l; Kievit, Adriana L.H.m; Thorsgaard, Nielsm; Katsanos, Konstantinos H.t; Christodoulou, Dimitrios K.t; Magro, Fernandou,v; Salupere, Riinaw; Pedersen, Natalian; Kjeldsen, Jenso; Carlsen, Katrinep; Ioannis, Kaimakliotix; Bergemalm, Daniely; Halfvarson, Jonasy; Duricova, Danai; Bortlik, Martini; Collin, Pekka; Oksanen, Pia; Kiudelis, Gediminas; Kupcinskas, Limas; Kudsk, Karenq; Andersen, Vibeker; O’Morain, Colm§; Bailey, Yvonne§; Doron, Schwartz; Shmuel, Odes; Almer, Svenz,*; Arebi, Nailac; Misra, Ravic; Čuković-Čavka, Silvija; Brinar, Marko; Munkholm, Pias; Vegh, Zsuzsanna#; Burisch, Johans

European Journal of Gastroenterology & Hepatology: November 2018 - Volume 30 - Issue 11 - p 1297–1303
doi: 10.1097/MEG.0000000000001238
Original Articles: Gastroenterology

Background Serum vitamin D level is commonly low in patients with inflammatory bowel disease (IBD). Although there is a growing body of evidence that links low vitamin D level to certain aspects of IBD such as disease activity and quality of life, data on its prevalence and how it varies across disease phenotype, smoking status and treatment groups are still missing.

Materials and methods Patients diagnosed with IBD between 2010 and 2011 were recruited. Demographic data and serum vitamin D levels were collected. Variance of vitamin D level was then assessed across different treatment groups, disease phenotype, disease activity and quality of life scores.

Results A total of 238 (55.9% male) patients were included. Overall, 79% of the patients had either insufficient or deficient levels of vitamin D at diagnosis. Patients needing corticosteroid treatment at 1 year had significantly lower vitamin D levels at diagnosis (median 36.0 nmol/l) (P=0.035). Harvey–Bradshaw Index (P=0.0001) and Simple Clinical Colitis Activity Index scores (P=0.0001) were significantly lower in patients with higher vitamin D level. Serum vitamin D level correlated significantly with SIBQ score (P=0.0001) and with multiple components of SF12. Smokers at diagnosis had the lowest vitamin D levels (vitamin D: 34 nmol/l; P=0.053).

Conclusion This study demonstrates the high prevalence of low vitamin D levels in treatment-naive European IBD populations. Furthermore, it demonstrates the presence of low vitamin D levels in patients with IBD who smoke.

aGastroenterology Division, Mater Dei Hospital, Malta

bIBD Unit, Hull and East Yorkshire NHS Trust

cIBD Department St Mark’s Hospital, London, UK

dDepartment of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua

eU.O. Gastroenterologia ed Endoscopia Digestiva, Ospedale Morgagni, Pierantoni, Forlì, Italy

fMedical Department, The National Hospital of the Faroe Islands, Torshavn, Faroe Islands

gClinic of Gastroenterology, University of Medicine ‘Victor Babes’, Timisoara, Romania, Balkans

hHospital Budweis, South Bohemia

iIBD Clinical and Research Centre Iscare, Prague, Czech Republic

jDepartment of Gastroenterology, Hospital Povisa, Vigo

kDepartment of Gastroenterology, Instituto de Investigación Biomédica Galicia Sur. Estrutura Organizativa de Xestión Integrada de Vigo, Spain

lDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus


nGastroenterology Department Slagelse Hospital, Slagelse

oGastroenterology Department, Odense University Hospital, Odense C

pDepartment of Pediatrics, Hvidovre Hospital, University of Copenhagen, Hvidovre

qMedical Department, Viborg Regional Hospital, Viborg

rFocused Research Unit for Molecular Diagnostic and Clinical Research, IRS-Center Sonderjylland, Hospital of Southern Jutland, Aabenraa

sDepartment of Gastroenterology, North Zealand University Hospital, Roskilde, Denmark

tDivision of Gastroenterology, Medical School and University Hospital of Ioannina, Greece

uGastroenterology Department, Hospital São João

vInstitute of Pharmacology and Therapeutics Faculty of Medicine of the University of Porto, Porto, Portugal

wTartu University Hospital, University of Tartu, Tartu, Estonia

xNicosia Private Practice, Cyprus

yDepartment of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro

zDepartment of Medicine, Solna, Karolinska Institutet

*Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden

Pekka Collin Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland

Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania

§Department of Gastroenterology, Adelaide and Meath Hospital, TCD, Dublin, Ireland

Department of Gastroenterology and Hepatology, Soroka Medical Centre, Ben-Gurion University of the Negev, Faculty of Health Sciences, Beer-Sheva, Israel

University Hospital Center Zagreb, School of Medicine University of Zagreb, Zagreb, Croatia

#Semmelweis University, Budapest, Hungary

Correspondence to Stefania Chetcuti Zammit, MD, MRCP, Gastroenterology Division, Mater Dei Hospital, MSD 2090 Malta, UK Tel: +36 356 2545 7570; e-mail:

Received December 17, 2017

Accepted March 19, 2018

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