La supplémentation en vitamine D est bénéfique contre la maladie de Crohn
The impact of vitamin D on disease activity in Crohn’s disease
Abdulrahman Aljebreen Appl. Physiol. Nutr. Metab. Vol. 40, 2015 p504
Canada has the highest rate of Inflammatory Bowel Disease (IBD) in the
world (0.67% of the population). One of the primary nutritional health
issues faced by Crohn’s disease (CD) patients is vitamin D deficiency; this
can subsequently lead to more serious health complications. VitaminD is
shown to act as a modulator for the autoimmune system among CD
patients. It has been suggested that optimal vitaminD status is beneficial
in treating CD as higher levels of vitamin D may significantly decrease
disease activity.
We sought to determine the association between vitaminD concentrations
and disease activity in a cohort of patients with CD
over three years.Aretrospective cohort design was used to determine the
association between vitamin D concentrations and disease activity
among CD cohort in Saskatoon, Canada. Two hundred and one CD patients
were studied; 116 participants had serum 25OHD measured at baseline.
Data was extracted from medical records over three years at IBD
clinic, Royal University Hospital, Saskatoon, Canada.
We evaluated the association between serum 25OHD concentrations and disease activity
indicators including high sensitivity C-reactive protein (hsCRP) and
Harvey-Bradshaw index (HBI) inCDpatients. The analyses was conducted
in the presence of other potential factors in three-time points (baseline,
midpoint, last visit) using generalized estimating equation (GEE). Serum
25OHD concentrations improved significantly from baseline to the
last visit (p=0.005). Mean serum 25OHD concentrations were 58.2±
30.0 nmol/L, 60.1±31.2 nmol/L, and 74.5±42.6 nmol/L at the baseline, midpoint
(mean 8 months), and final visit (mean 15 months) respectively.
Compared to vitamin D deficient category, patients in other categories
including insufficient, adequate and optimal levels, had significantly
lower hsCRP level over 15 months (p <0.05). Only the insufficient category
of vitaminD status was significantly associated with higher HBI score (≥5
active disease). Higher vitamin D concentrations were associated with
lower disease activity levels in Crohn’s patients over 15 months. Proper
vitamin D complementation and regular assessment of vitamin D status
are warranted in Crohn’s diseases patients.