ISG Winter Meeting 2015
First Prize Poster
Our Lady's Childrens Hospital Crumlin, Dublin
The association between serum vitamin D status and disease activity in paediatric inflammatory bowel disease
O’ Neill, E, Raftery, T, Broderick, A, Bourke, B, Hussey S
Our Lady's Children's Hospital Crumlin, National Children's Research Centre, Health Research Board
The role of vitamin D has been investigated in numerous inflammatory conditions including inflammatory bowel disease (IBD). Paediatric and adult studies show vitamin D status associates with disease initiation, progression and severity. This had yet to be investigated in an Irish paediatric cohort.
(1) To determine the vitamin D status at diagnosis of paediatric IBD patients referred to the National Centre for Paediatric Gastroenterology. 2) To describe differences in vitamin D status observed between children diagnosed with Crohn’s disease (CD) and ulcerative colitis (UC). 3) To investigate associations between vitamin D status and markers of systemic (C creative protein, CRP), and intestinal inflammation (faecal calprotectin, FC) and disease activity (Paedaitric Ulcerative Colitis Activity Index, PUCAI score/ Paedatric Crohn Disease Activity Index, PCDAI score).
Data was obtained from the Determinants and Outcomes in Children and Adolescents with IBD Study (DOCHAS). Classification of patients was based on diagnosis at recruitment. Vitamin D status was compared with PUCAI/ PCDAI, CRP status, and FC status. Serum 25(OH)D concentration was used to assess vitamin D status. Vitamin D deficiency was defined as serum 25(OH)D <50nmol/l.
Three hundred and thirty-eight children were included (Table1). 25(OH)D was suboptimal in 80.7% of cases. Serum 25(OH)D inversely correlated with PCDAI (r = -0.490, p = <0.001), age (r = -0.367, p = <0.001) and CRP (r = -0.534, p = <0.001). Correlation analysis was non-significant between serum 25(OH)D and FC (r=-0.084, p=0.724), and PUCAI (r=-0.239, p=0.123). ANOVA test showed no significance between 25(OH)D status and season, diagnosis, or living arrangement.
Vitamin D deficiency is common in paediatric IBD irrespective of diagnosis, season or living arrangement. Serum 25(OH)D inversely associates with systemic inflammation (CRP) and severity of disease in CD (PCDAI). Further study is warranted, as reverse causality cannot be excluded.Year-round supplementation of vitamin D should be considered. Investigation of the affect of vitamin D supplementation on disease activity in paediatric CD is advisable.