Observational Study
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World J Gastroenterol. Nov 14, 2014; 20(42): 15787-15796
Published online Nov 14, 2014. doi: 10.3748/wjg.v20.i42.15787
Higher vitamin D serum concentration increases health related quality of life in patients with inflammatory bowel diseases
Tibor Hlavaty, Anna Krajcovicova, Tomas Koller, Jozef Toth, Monika Nevidanska, Martin Huorka, Juraj Payer
Tibor Hlavaty, Anna Krajcovicova, Tomas Koller, Jozef Toth, Monika Nevidanska, Martin Huorka, Department of Internal Medicine, Division of Gastroenterology and Hepatology, University Hospital Bratislava, Ruzinov, 82606 Bratislava, Slovakia
Juraj Payer, Department of Internal Medicine, Center for Osteoporosis and Metabolic Bone Diseases, University Hospital Bratislava, Ruzinov, 82606 Bratislava, Slovakia
Author contributions: Hlavaty T designed the study, collected the data, did the statistical analyses and wrote the manuscript; Krajcovicova A collected the data, prepared the database and reviewed the manuscript; Koller T, Toth J and Huorka M collected the data and reviewed the manuscript; Nevidanska M collected the data; and Payer J designed the study and reviewed the manuscript.
Supported by Grant from the Slovak APVV agency, No. APVV-0672-11
Correspondence to: Tibor Hlavaty, MD, PhD, Associate Professor, Department of Internal Medicine, Division of Gastroenterology and Hepatology, University Hospital Bratislava, Ruzinovska 6, 82606 Bratislava, Slovakia. tibor.hlavaty2@gmail.com
Telephone: +421-2-48234905 Fax: +421-2-48234905
Received: April 1, 2014
Revised: May 21, 2014
Accepted: June 13, 2014
Published online: November 14, 2014
Processing time: 229 Days and 15.6 Hours
Abstract

AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.

METHODS: A cohort of 220 IBD patients including 141 Crohn’s disease (CD) and 79 ulcerative colitis (UC) patients was followed-up at a tertiary IBD center. A subgroup of the cohort (n = 26) took VD supplements for > 3 mo. Health related quality of life was assessed using the short IBD questionnaire (sIBDQ). VD serum concentration and sIBDQ score were assessed between August and October 2012 (summer/autumn period) and between February and April 2013 (winter/spring period). The mean VD serum concentration and its correlation with disease activity of CD were determined for each season separately. In a subgroup of patients, the effects of VD supplementation on winter VD serum concentration, change in VD serum concentration from summer to winter, and winter sIBDQ score were analyzed.

RESULTS: During the summer/autumn and the winter/spring period, 28% and 42% of IBD patients were VD-deficient (< 20 ng/mL), respectively. In the winter/spring period, there was a significant correlation between sIBDQ score and VD serum concentration in UC patients (r = 0.35, P = 0.02), with a trend towards significance in CD patients (r = 0.17, P = 0.06). In the winter/spring period, VD-insufficient patients (< 30 ng/mL) had a significantly lower mean sIBDQ score than VD-sufficient patients; this was true of both UC (48.3 ± 2.3 vs 56.7 ± 3.4, P = 0.04) and CD (55.7 ± 1.25 vs 60.8 ± 2.14, P = 0.04) patients. In all analyzed scenarios (UC/CD, the summer/autumn period and the winter/spring period), health related quality of life was the highest in patients with VD serum concentrations of 50-59 ng/mL. Supplementation with a median of 800 IU/d VD day did not influence VD serum concentration or the sIBDQ score.

CONCLUSION: VD serum concentration correlated with health related quality of life in UC and CD patients during the winter/spring period.

Keywords: Vitamin D; Crohn’s disease; Ulcerative colitis; Health related quality of life; Vitamin D supplementation

Core tip: In a cohort of 220 inflammatory bowel disease (IBD) patients, we observed that vitamin D (VD)-insufficient patients (< 30 ng/mL) had a lower health related quality of life (sIBDQ) in the winter/spring period. In all analyzed scenarios (ulcerative colitis/Crohn’s disease, the summer/autumn and the winter/spring period), the health related quality of life was the highest in patients with VD serum concentrations of 50-59 ng/mL, indicating a possible target level for therapeutic VD supplementation. Furthermore, we observed that supplementation with currently recommended doses of VD supplementation of 800 IU/d VD did not influence VD serum concentration or the sIBDQ score.