Serum vitamin D levels in a cohort of adult and pediatric patients with eosinophilic esophagitis

Abstract

Background: Vitamin D deficiency has been associated with increased risk for severe asthma, challenge-proven food allergy, and severe atopic dermatitis. Vitamin D levels have not been reported in patients with eosinophilic esophagitis (EoE).

Objective: To determine levels of 25-hydroxyvitamin D in a cohort of patients with EoE.

Methods: Total serum 25-hydroxyvitamin D was measured using liquid chromatography with tandem mass spectroscopy in adults (n = 35) and children (n = 34) with EoE. Results were compared with patient demographics, EoE-specific disease parameters, markers of sensitization, and features of severity using multivariable logistic regression.

Results: The median vitamin D level was 28.9 ng/mL. Patients with insufficient vitamin D (<30 ng/mL) were older (median 25.5 vs 16.2 years) and had a higher body mass index (median 25.2 vs 19.8 kg/m(2)). Peak median esophageal eosinophil counts were not significantly different for vitamin D insufficient and sufficient patient groups; however, higher vitamin D levels correlated with higher histologic eosinophil counts (R = 0.61, P = .03). Although there were no statistical differences in total IgE or levels of specific IgE between patients with vitamin D insufficiency and those with sufficiency, a positive skin prick test reaction to peanut was more common in patients who had vitamin D insufficiency (adjusted odds ratio 7.57, P = .009). Vitamin D insufficiency was not associated with surrogate markers of severity (dilation in adults or hospitalization or emergency visits in children).

Conclusion: In these patients with EoE, vitamin D levels were low overall (median <30 ng/mL). The only marker of sensitization associated with insufficient vitamin D in these patients with EoE was a positive skin prick test reaction to peanut.

Figure 1

Distribution of serum vitamin D levels in the study population. The height of each bar represents the total number of patients having a vitamin D level within each range. Children (black bars) and adults (gray bars) are shown separately.

Figure 2

For each patient, vitamin D status as insufficient or sufficient is represented and each patient’s home location is shown by ZIP code.

Figure 3

Box-and-whisker plots show levels of serum vitamin D based on season of recruitment. A line represents the median vitamin D level. Values between the 25th and 75th percentiles are contained within the box, and whiskers extend to the maximum and minimum levels. Outliers are represented by individual dots.

Figure 4

Correlation between serum vitamin D level and esophageal eosinophil counts. The solid line depicts the R value. The dashed line at 30 ng/mL divides vitamin D insufficient levels from sufficient levels.