Vitamin D deficiency is associated with endoscopic severity in patients with Crohn's disease

Abstract

Background and Aims. Vitamin D deficiency is common in patients with Crohn's disease and is associated with disease activity. Relationship between Vitamin D and endoscopic disease activity is unknown. The aim of the study is to determine the association between Vitamin D status and endoscopic disease activity in CD patients. Methods. Consecutive hospitalized CD patients from 2014 to 2016 who received Vitamin D assessment and colonoscopy were retrospectively evaluated. Clinical disease activity was assessed by Crohn's disease activity index and C-reactive protein. Endoscopic activity was calculated using simple endoscopic score for Crohn's disease. Results. Median serum 25OHD level of 131 patients was lower than healthy controls [21.1 nmol/L (11.8-32.3) versus 49.9 nmol/L (44.9-57.4), P=0.007]. 125 (95%) patients had Vitamin D deficiency and the rest (5%) had Vitamin D insufficiency. Serum 25OHD was inversely correlated with CRP (r=-0.308, P<0.001), CDAI (r=-0.582, P<0.001), SES-CD (r=-0.294, P=0.001), and endoscopic severity stratified by SES-CD (P=0.001). Conclusion. Vitamin D deficiency was prevalent among hospitalized CD patients. Vitamin D levels were inversely correlated with endoscopic disease activity. Vitamin D status could be a biomarker in assessing disease activity among hospitalized CD patients in addition to CDAI and CRP.