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Association Between Inflammatory Bowel Disease and Vitamin D Deficiency: A Systematic Review and Meta-analysis
Rita Del Pinto1, Davide Pietropaoli, Apoorva K Chandar
1*Division of Internal Medicine, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy; †Division of Gastroenterology and Liver Disease, Case Western Reserve University, Cleveland, Ohio; ‡Division of Dentistry, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy; and §Digestive Health Institute, University Hospitals Case Medical Center, Cleveland, Ohio.
Background:
Vitamin D plays a role in several immune-mediated diseases, but its association with inflammatory bowel disease (IBD) is unclear. We conducted a systematic review and meta-analysis to assess the association between IBD and vitamin D deficiency.
Methods:
We searched electronic databases from inception to December 2014 for observational studies reporting the presence of vitamin D deficiency (defined as serum 25-hydroxycholecalciferol [25(OH)D] level of ≤20 ng/mL) in IBD patients and having a control group without IBD. Odds ratios (ORs) were combined using a random-effects model. Meta-regression was performed using latitude as a moderator. Study quality was assessed using the Newcastle-Ottawa scale.
Results:
Out of 816 citations, 14 eligible studies were identified, comprising 1891 participants (938 IBD cases and 953 controls). Meta-analysis showed that patients with IBD had 64% higher odds of vitamin D deficiency when compared with controls (OR = 1.64; 95% confidence interval, 1.30-2.08; I = 7%; P < 0.0001). Patients with ulcerative colitis had more than double the odds of vitamin D deficiency when compared with normal controls (OR = 2.28; 95% confidence interval, 1.18-4.41; I = 41%; P = 0.01). Latitude did not influence the association between IBD and vitamin D deficiency (P = 0.34). Generalizability of our results might be limited as we summarized unadjusted ORs, because of nonavailability of adjusted ORs in individual studies.
Conclusions:
IBD is significantly associated with having higher odds of vitamin D deficiency. Well-designed randomized controlled trials and longitudinal studies are needed to further explain the role of vitamin D in IBD pathogenesis and its therapy.
