Original ResearchClinical—Alimentary TractHigher Predicted Vitamin D Status Is Associated With Reduced Risk of Crohn's Disease
Section snippets
Study Population
The NHS is a prospective cohort that began in 1976 when 121,700 US female registered nurses, ages 30 to 55 years, completed a mailed health questionnaire. With a follow-up response rate of more than 90%, questionnaires have been mailed every 2 years to update health information. In 1980, comprehensive dietary and supplement information was obtained through a validated semiquantitative food frequency questionnaire from which intake of vitamin D could be derived.16, 17 In 1986 the
Results
Among the 72,719 women included, we documented 122 cases of CD and 123 cases of UC during 1,492,811 person-years of follow-up evaluation. At baseline, the median age of participants was 53 years (range, 40–73 y). The median predicted 25(OH)D level was 27.6 ng/mL (range, 7.3–38.6 ng/mL). Table 1 presents the characteristics of the study cohort in 1986 according to the quartile distribution of predicted plasma 25(OH)D level. As expected, women in the lowest quartile of predicted 25(OH)D level had
Discussion
Although deficiency of vitamin D commonly has been described in patients with newly diagnosed IBD,29 it is unclear if this is a consequence of the disease or a contributor to its pathogenesis. In this prospective cohort study, we show that predicted levels of prediagnosis plasma 25(OH)D are associated with a significant reduction in risk of incident CD and nonsignificant reduction in risk of UC over a follow-up period of 22 years. Taken together, our results suggest that vitamin D may be an
Acknowledgments
The authors thank Gideon Aweh for computer programming expertise and acknowledge the dedication of the Nurses Health Study participants and members of Channing Laboratory.
References (49)
Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences
Gastroenterology
(2004)- et al.
1,25-Dihydroxycholecalciferol prevents and ameliorates symptoms of experimental murine inflammatory bowel disease
J Nutr
(2000) - et al.
Vitamin D status, 1,25-dihydroxyvitamin D3, and the immune system
Am J Clin Nutr
(2004) Vitamin D status: measurement, interpretation, and clinical application
Ann Epidemiol
(2009)- et al.
Validation of a semi-quantitative food frequency questionnaire: comparison with a 1-year diet record
J Am Diet Assoc
(1987) Tobacco and IBD: relevance in the understanding of disease mechanisms and clinical practice
Best Pract Res Clin Gastroenterol
(2004)Epidemiology of disease risks in relation to vitamin D insufficiency
Prog Biophys Mol Biol
(2006)- et al.
Crohn's disease: the hot hypothesis
Med Hypotheses
(2009) - et al.
Direct and indirect induction by 1,25-dihydroxyvitamin D3 of the NOD2/CARD15-defensin beta2 innate immune pathway defective in Crohn disease
J Biol Chem
(2010) - et al.
Validation of a dietary questionnaire with plasma carotenoid and alpha-tocopherol levels
Am J Clin Nutr
(1983)
Correlations of vitamin A and E intakes with the plasma concentrations of carotenoids and tocopherols among American men and women
J Nutr
Inflammatory bowel disease
N Engl J Med
Unravelling the pathogenesis of inflammatory bowel disease
Nature
Meta-analysis identifies 29 additional ulcerative colitis risk loci, increasing the number of confirmed associations to 47
Nat Genet
Genome-wide meta-analysis increases to 71 the number of confirmed Crohn's disease susceptibility loci
Nat Genet
Mechanisms of disease: vitamin D and inflammatory bowel disease
Nat Clin Pract Gastroenterol Hepatol
Candidate genes colocalized to linkage regions in inflammatory bowel disease
Digestion
Association of vitamin D receptor gene polymorphisms in Iranian patients with inflammatory bowel disease
J Gastroenterol Hepatol
Vitamin D receptor gene polymorphism: association with Crohn's disease susceptibility
Gut
The BsmI vitamin D receptor gene polymorphism is associated with ulcerative colitis in Jewish Ashkenazi patients
Genet Test
Cholecalciferol plus calcium suppresses abnormal PBMC reactivity in patients with multiple sclerosis
J Clin Endocrinol Metab
Vitamin D deficiency
N Engl J Med
The use of a self-administered questionnaire to assess diet four years in the past
Am J Epidemiol
Prospective study of predictors of vitamin D status and cancer incidence and mortality in men
J Natl Cancer Inst
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Conflicts of interest These authors disclose the following: Joshua Korzenik has been a consultant for Procter and Gamble, Shire Pharmaceuticals, CytokinePharma, and receives research support from Procter and Gamble and Warner Chilcott; James Richter is a consultant for Policy Analysis, Inc; and Andrew Chan has served as a consultant for Bayer HealthCare and Millennium Pharmaceuticals. The remaining authors disclose no conflicts.
Funding This work was supported by a Research Scholars Award of the American Gastroenterological Association (A.N.A.), the IBD Working Group (H.K.), the Broad Medical Research Program of the Broad Foundation (A.T.C), and the National Institutes of Health (R01 CA137178, P01 CA87969, P30 DK043351, and K08 DK064256).
The research presented in this manuscript is original. The contents of this article are solely the responsibility of the authors. The American Gastroenterological Association and the Broad Medical Research Foundation had no role in the collection, management, analysis, or interpretation of the data and had no role in the preparation, review, or approval of the manuscript.