Introduction There is increasing interest in the role of vitamin D in IBD, outside of its traditional role in metabolic bone disease. Novel insights into additional roles for vitamin D are being established and these include anti-inflammatory and immune-modulating effects. Active vitamin D is known to exert its biological functions via the vitamin D receptor (VDR). Immune cells have been found to express VDR and possess the enzymes necessary to produce active vitamin D. This suggests vitamin D may have actions beyond endocrine activity. Furthermore, Vitamin D deficiency has been linked to higher rates of cancers including colorectal cancer. Previous studies have found that almost 50% of the IBD patients were vitamin D deficient at some point and 11% were severely deficient. Vitamin D deficiency has been demonstrated to be independently associated with higher disease activity scores in patients compared to those that had normal levels of vitamin D. Furthermore, vitamin D deficient Crohn's patients have a poorer quality of life when compared to patients who are not vitamin D deficient. Currently, ECCO guidelines do not mention measurement of vitamin D in patients with IBD but given its effects, we set out to identify whether we were checking for and correcting for vitamin D deficiency in our IBD patients.
Methods The aim of the study was to investigate whether we were measuring vitamin D levels at any encounter in out IBD patients. This study was conducted in a busy District General Hospital in North London. Information was gathered using the hospital powerchart system and the IBD database of patients.
Results A total of 225 patients were correctly identified as having IBD. Of these, 157 (70%) had Ulcerative colitis and 68 (30%) had Crohn's disease. 24 (15%) Ulcerative colitis patients and 8 (12%) Crohn's patients had their vitamin D checked on hospital records. The range of vitamin D levels were 14–84 with lower limit of normal being 50. 13/32 (41%) patients has low vitamin D levels Of these only two patients were also under the Rheumatology team for co-existing arthropathy/arthritis.
Conclusion This study demonstrates that despite evidence of Vitamin D and its role in anti-inflammatory and immune-modulating effects (in addition to bone protection) we are not actively measuring and treating its deficiency. Perhaps guidance from ECCO may encourage our testing of vitamin D in IBD patients.
Competing interests None declared.
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