Study of Vitamin D Status in Patients with Ulcerative Colitis in Egypt

Background and aim of the work: There is increasing interest in the role of vitamin D in inflammatory bowel disease(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. Therefore, this study was planned to assess the level of vitamin D variations among ulcerative colitis patients in Egypt. After departmental ethical committee approval and participants consent were obtained Twenty(20) patients with ulcerative colitis(UC) (group I), and Ten(10) apparently healthy persons (group II) as control group were enrolled in the study. Ulcerative colitis patients was diagnosed through, full history taking, clinical assessment, laboratory investigations, colonoscopic and histopathological studies. The control group was subjected to diagnostic modalities aspatients group apart from Colonoscopic and histopathological studies, and matched with patients group for age and sex. Group (1) ages ranged from 21 - 60 years, mean age was (36.95) 13 were females (65%) and 7 were males (35%). Group (11) ages ranged from 20 -58 years, mean age was (37.60) 6 were females(60%) and 4 were males (40%). Results of this study revealed: The mean serum values of 25(OH) vitamin D in patients group(I) were lower in comparison to control group (II) (23.0±13.49 ng/dl and 36.2±5.9 ng/dl) respectively. This difference was statistically significant (P<0.007). Laboratory data of studied groups showed statistically significant difference between controls and patients group regarding HB, C-reactive protein, and serum calcium levels (P-value 0.000) respectively, as there were decreased level of HB and serum calcium in patients group compared to controls, however, increased CRP levels in patients group. White blood cells (WBCs) was higher in patients group compared to controls. In ulcerative colitis patients, there were inverse correlation between frequency of bloody stools/day and CRP with vitamin D levels which statistically significant (P= 0.003, 0.000) respectively. Serum calcium and vitamin D levels were in direct correlation and statistically significant (P=0.000). There were no correlation between age, WBCs, platelets, s. albumin, s. creatinine and INR with vitamin D levels. The patient group was classified into 3 subgroups: deficiency subgroup (9 patients) with main serum values of 25(OH) vitamin D (14.4±2.86 ng/ml), insufficiency subgroup (8 patients) (24.19±2.76 ng/ml) and sufficiency subgroup(3 patients) (33.67±3.06 ng/ml.). There was an evidence of exacerbation of activity of ulcerative colitis correlated to the degree of decreasing of vitamin D level. There were significant increase in frequency of bloody stool motions/day, ESR, and C-reactive protein (CRP), with the degree of decrease of vitamin D levels in patients subgroups. However, there were decrease of haemoglobin, serum phosphate & calcium with the degree of lowered vitamin D level in patients with ulcerative colitis. Conclusions: vitamin D (25(OH) D) deficiency is common in ulcerative colitis patients, the increased the degree of vitamin D deficiency, is associated with the increased the degree of activity of ulcerative colitis disease, which may support suggestion of vitamin D level is a potential contributing factor underlying the pathogenesis and disease activity of ulcerative colitis.