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Vitamin D therapy in pediatric patients with inflammatory bowel disease: a systematic review and meta-analysis
Mohammad Hassan Sohouli1,2, Fatemeh Farahmand1, Hosein Alimadadi1
1Pediatric Gastroenterology and Hepatology Research Center, Pediatrics Centre of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Vitamin D supplementation significantly improves vitamin D and calcium levels, and reduces inflammation in pediatric patients with inflammatory bowel disease (IBD). Higher doses and longer follow-up periods showed greater benefits for children with IBD.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Immunology
Background:
- Conflicting evidence exists regarding vitamin D deficiency's role in pediatric inflammatory bowel disease (IBD) pathogenesis.
- A systematic review and meta-analysis were conducted to clarify vitamin D's effect on pediatric IBD patients.
Conclusions:
- Vitamin D therapy demonstrates a significant beneficial effect on 25(OH)D3, calcium, and inflammatory factors in pediatric IBD patients.
- Optimal benefits were noted with vitamin D doses exceeding 2000 IU and follow-up durations longer than 12 weeks.
Background:
There is some evidence for the role of vitamin D deficiency in the pathogenesis of inflammatory bowel disease (IBD) in the pediatric population. However, the results are contradictory. Therefore, we have conducted a systematic review and meta-analysis to evaluated the effect of vitamin D on pediatric patients with IBD.
Methods:
We carried out a systematic search in databases from inception until 20 January 2022. We included all relevant articles that evaluate the efficacy and safety of vitamin D on disease activity, inflammatory factors, and vitamin D and calcium levels in pediatric patients with IBD. Random effects models were used to combine the data. The main outcomes were then analyzed using weight mean difference (WMD) and respective 95% confidence interval (CI).
Results:
Fifteen treatment arms met the eligibility criteria and were included. Pooled estimates indicated that intervention with vitamin D has a significantly beneficial effect on 25-hydroxyvitamin D3 [25(OH) D3] (pooled WMD of 17.662 ng/mL; CI 9.77-25.46; P < 0.001), calcium (pooled WMD of 0.17 mg/dL; CI 0.04-0.30; P = 0.009), and inflammatory factors including C-reactive protein (CRP) (pooled WMD of -6.57 mg/L; CI -11.47 to -1.67; P = 0.009) and erythrocyte sedimentation rate (ESR) (pooled WMD of -7.94 mm/h; CI -12.65 to -3.22; P = 0.001) levels. In addition, this effect was greater for vitamin D levels at doses greater than 2000 IU, and when follow-up duration was more than 12 weeks.
Conclusion:
This study showed that vitamin D therapy can have a significant and beneficial effect on 25(OH) D3, calcium, and inflammatory factors in children and adolescents with IBD.
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