Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2017; 23(4): 638-645
Published online Jan 28, 2017. doi: 10.3748/wjg.v23.i4.638
Predictors of vitamin D deficiency in inflammatory bowel disease and health: A Mississippi perspective
Kumar Pallav, Daniel Riche, Warren L May, Patrick Sanchez, Nitin K Gupta
Kumar Pallav, Patrick Sanchez, Nitin K Gupta, Division of Digestive Diseases, University of Mississippi Medical Center, Jackson, MS 39216, United States
Daniel Riche, Warren L May, Department of Pharmacy Practice, University of Mississippi Medical Center, Jackson, MS 39216, United States
Author contributions: Pallav K designed research, acquired data and wrote the manuscript; Riche D and Gupta NK designed research, critically reviewed the manuscript; Sanchez P acquired data and assisted with manuscript preparation; May WL designed research, analyzed data.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of University of Mississippi Medical Center.
Informed consent statement: Informed consent was not obtained for this retrospective chart review.
Conflict-of-interest statement: None of the authors have any disclosures relevant to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kumar Pallav, MBBS, Assistant Professor, Division of Digestive Diseases, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, United States. drkumarpallav@yahoo.com
Telephone: +1-601-9844540 Fax: +1-601-9844538
Received: September 4, 2016
Peer-review started: September 6, 2016
First decision: October 11, 2016
Revised: December 5, 2016
Accepted: December 21, 2016
Article in press: December 21, 2016
Published online: January 28, 2017
Abstract
AIM

To identify the predictors of vitamin D deficiency in patients with and without inflammatory bowel disease (IBD).

METHODS

Patients with ulcerative colitis (UC) or Crohn’s disease (CD) related diagnostic codes who received medical care at University of Mississippi Medical Center between July 2012 and 2015 were identified. After thorough chart review, we identified patients with biopsy proven IBD who had also been tested for serum 25-hydroxyvitamin D [25(OH)D] concentration. We compared these patients to a previously studied cohort of healthy controls who also had vitamin D concentration checked. Logistic regression analysis was performed to determine the association between vitamin d deficiency and UC, CD, race, age, gender and body mass index (BMI).

RESULTS

We identified 237 patients with confirmed IBD. Of these, only 211 had a serum 25(OH)D concentrations available in the medical record. The group of healthy controls consisted of 98 individuals with available serum 25(OH)D concentration. 43% of IBD patients were African American (AA). Patients with CD were more likely to have vitamin D concentration checked. Bivariate analysis showed that AA (51% vs 21%, P = 0.00001), subjects with BMI >30 kg/m2 (39% vs 23% P = 0.01) and CD (40% vs 26%, P = 0.04) were more likely to be vitamin D deficient than vitamin D sufficient. Those with Age > 65 were more likely to be vitamin D sufficient (46% vs 15%, P = 0.04). Multiple regression showed that only BMI > 30 kg/m2 and AA race are associated with vitamin D deficiency.

CONCLUSION

BMI > 30 kg/m2 and AA race are predictive of vitamin D deficiency. Gender, age and diagnosis of IBD are not predictive of vitamin D deficiency.

Keywords: Vitamin D deficiency, Inflammatory bowel disease, Body mass index, Ulcerative colitis, Crohn’s disease, African American

Core tip: The studies evaluating the relationship between vitamin D deficiency and inflammatory bowel disease (IBD) have shown heterogeneity perhaps due to multiple overlapping risk factors that need to be accounted for. We performed a retrospective study to identify the risk factors for vitamin D deficiency in a population with a large African American (AA) component. Using logistic regression analysis we studied the effect of diagnosis, race, age, gender and body mass index (BMI) on prevalence of vitamin D deficiency. In subjects with and without IBD, BMI > 30 kg/m2 and AA race are predictive of vitamin D deficiency. Gender, age and diagnosis of IBD were not predictive of vitamin D deficiency in our population.