A new study found that healthy vitamin D levels increased the odds of remission among inflammatory bowel disease patients who had just begun treatment.
Inflammatory bowel disease (IBD) is characterized by chronic inflammation of all or part of the digestive tract. IBD includes ulcerative colitis (UC) and Crohn’s disease (CD); both of which typically result in severe diarrhea, fatigue, weight loss pain, fistulas and even death.
IBD treatments aim to reduce the inflammation that triggers symptoms. Ideally, the treatment leads to symptom relief, long-term remission and reduced complications. These treatments typically include drug therapy or surgery.
Due to vitamin D’s combination of anti-microbial and anti-inflammatory properties, researchers became interested in the relationship between vitamin D and IBD. Studies have discovered that vitamin D deficient IBD patients experience an increased risk of IBD complications, such as hospitalizations, surgical resection, infections and cancer. A previous study also found that vitamin D levels may affect the duration of treatment with anti-tumor necrosis factor-α (anti TNF-α), a commonly used treatment for IBD that helps the gastrointestinal tract heal and improves patients’ quality of life.
In a new study, researchers from the Brigham and Women’s Hospital, Boston, MA, evaluated the relationship between vitamin D levels and odds of achieving remission while on anti TNF- α medication. The researchers analyzed the relationship between vitamin D levels and the rate of remission among a total of 173 IBD patients on anti TNF- α medication.
The study found that a total of 122 patients had healthy vitamin D levels, and 51 had low vitamin D levels. Nearly 80% of the patients with healthy vitamin D levels entered remission within three months of beginning the anti TNF- α medication; whereas, only about 20% of patients with low vitamin D levels entered remission (p = 0.0045). The statistical analysis revealed that patients with healthy vitamin D levels at the time of anti TNF-α medication initiation had a 2.64 increased odds of remission at 3 months compared to patients with low vitamin D levels when controlling for age, gender, diagnosis and other confounding factors (p = 0.0067).
The researchers concluded,
“These results show a significant association between vitamin D levels and rates of remission among patients with IBD. Specifically, patients who had low vitamin D levels prior to treatment had decreased odds of being in remission after 3 months of treatment with anti TNF-α therapy.”
The study consisted of several limitations. First, the number of patients included was relatively small. Second, the study took place at only one location. Both study design traits decreased the study’s generalizability, the ability to apply these findings to the public. The study was not prospective, which didn’t allow the study to determine the anti TNF-α medication’s response to vitamin D deficiency. Lastly, the researchers received the patients’ vitamin D levels from various laboratories. Many of these labs defined healthy and low vitamin D levels differently, which could potentially skew the results.
Tovey, A. & Cannell, JJ. Healthy vitamin D levels may increase odds of remission among inflammatory bowel disease patients. The Vitamin D Council Blog & Newsletter, 2017.
Winter, R. et al. Higher 25-hydroxyvitamin D levels are associated with greater odds of remission with anti-tumor necrosis factor-α medications among patients with inflammatory bowel diseases. Alimentary Pharmacology and Therapeutics, 2016.