Introduction The role of vitamin D in inflammation and its possible cancer protective effects are now coming to the fore. Inflammatory bowel disease (IBD) provides a model where both roles can be assessed. Early studies have indicated that vitamin D deficiency is common amongst patients with this condition. Leicester in the UK has a significant population of patients from both English and South Asian backgrounds and so allows comparisons to be made between people of different ethnicities and different experiences of vitamin D deficiency.
Methods Vitamin D (25 OH D) status was measured in 148 consecutive patients with IBD, who attended the gastroenterology clinics during a period of one year (Jan to Dec 2011). Vitamin D levels were graded as severe deficiency (< 15 nmol/l), moderate deficiency (16–30 nmol/l), insufficiency (31–50 nmol/l ), adequate (51–75 nmol/l), and ideal (> 76 nmol/l). All case notes were reviewed and data analysed using χ2 statistic.
Results 148 patients had IBD, 64% were women and 36% men. 93 patients (61%) with ulcerative colitis (UC) and 55 (39%) Crohns disease (CD). Of the 93 patients with UC, 50 were English and 43 South Asian. Of the 55 patients with CD, 43 were English and 12 of South Asian background. The proportions amongst both communities and across the disease groups were not significantly different when analysed with a χ2 statistics.
Conclusion Vitamin D deficiency is common in all patients with inflammatory bowel disease. It plays a vital role in bone health, immune regulation and cancer prevention in IBD. The optimal target level of 25(OH) vitamin D in IBD patients is uncertain as is the best therapeutic modality. The precise threshold for 25(OH) vitamin D level is poorly defined in the literature and so is the dosing and duration of treatment. Its frequency is almost similar in South Asian and English patients with Crohn’s disease which suggests that mal-absorption of the vitamin may play a part in the vitamin D deficiency. In contrast it is commoner in South Asian patients with ulcerative colitis than amongst English patients and this warrants further investigation. It may suggest that in the future South Asian patients will be at greater risk of colonic carcinoma as a complication of ulcerative colitis.
Disclosure of Interest None Declared.
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