Patients With IBD, Chronic Liver Disease at Increased Risk of Vitamin D Deficiencies

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Title: Patients With IBD, Chronic Liver Disease at Increased Risk of Vitamin D Deficiencies
URL: http://www.pslgroup.com/dg/22E46E.htm
Doctor's Guide
October 7, 2008

ORLANDO, Fla -- October 7, 2008 -- Patients with inflammatory bowel disease (IBD) or chronic liver disease are at increased risk of developing vitamin D deficiencies, according to 2 studies presented at the American College of Gastroenterology 73rd Annual Scientific Meeting in Orlando, Florida.

In the first study, Alex Ulitsky, MD, Medical College of Wisconsin, Milwaukee, Wisconsin, and colleagues investigated whether vitamin D deficiency in patients with IBD is associated with a lower quality of life or higher disease activity independent of other known risk factors and medication use.

Disease activity and quality of life were assessed using validated questionnaires, which were administered at every clinic visit. The researchers also looked at the prevalence and seasonality of vitamin D deficiency in this IBD population, as well as its association with IBD-related hospitalisations, surgeries, and medication use.

This retrospective cohort study conducted analysed vitamin D levels of 504 patients with IBD. They recorded the patients' lowest vitamin D measurements and date when each low measurement was taken.

The researchers found almost 50% of the patients were vitamin D deficient at some point, with 11% being severely deficient. Vitamin D deficiency was not significantly associated with being hospitalised for IBD or having IBD-related surgeries.

However, in both Crohn's disease (CD) and ulcerative colitis (UC) patients, vitamin D deficiency was independently associated with having increased disease activity scores compared with those with normal levels of vitamin D. Vitamin D-deficient CD patients, but not UC patients, had worse quality of life when compared with patients who were not vitamin D deficient.

"All IBD patients, irrespective of their disease, disease location, or nature should have their vitamin D levels checked regularly and corrected aggressively when insufficiency is found," said Dr. Ulitsky.

In another study, researchers from the University of Tennessee, Memphis, Tennessee, measured the vitamin D levels in patients with chronic liver disease.

That study included 43 patients with hepatitis C virus (HCV) with cirrhosis, 57 patients with HCV without cirrhosis, and 18 patients with cirrhosis without HCV. The severity of vitamin D deficiency was divided into 3 groups: mild (20-32 ng/mL), moderate (7-20 ng/mL), and severe (< 7 ng/mL).

They found that 92.4% of the patients had some degree of vitamin D deficiency and at least one-third was severely deficient. Severe vitamin D deficiency was more common among cirrhotics.

"Since deficiency is common among these patients, vitamin D replacement may hopefully prevent osteoporosis and other bone complications related to end-stage liver disease," said lead researcher Satheesh P. Nair, MD, University of Tennessee.

SOURCE: American College of Gastroenterology

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