Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Sep;23(9):1650-1658.
doi: 10.1097/MIB.0000000000001178.

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

Sana Syed  1 , Ellen S Michalski, Vin Tangpricha, Supavit Chesdachai, Archana Kumar, Jarod Prince, Thomas R Ziegler, Parminder S Suchdev, Subra Kugathasan
Affiliations

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

Sana Syed et al. Inflamm Bowel Dis. 2017 Sep.

Abstract

Background: Anemia, iron deficiency, and hypovitaminosis D are well-known comorbidities in inflammatory bowel disease (IBD). Epidemiologic studies have linked vitamin D deficiency with increased risk of anemia, and in vitro studies suggest that vitamin D may improve iron recycling through downregulatory effects on hepcidin and proinflammatory cytokines.

Methods: We aimed to investigate the association of vitamin D status with inflammation, iron biomarkers, and anemia in pediatric IBD. Cross-sectional data were obtained from N = 69 patients with IBD aged 5 to <19 years. Iron biomarkers (ferritin, soluble transferrin receptor), and 25-hydroxyvitamin D (25(OH)D), inflammatory biomarkers (C-reactive protein and α-1-acid glycoprotein), hepcidin, and hemoglobin were collected. Iron biomarkers were regression corrected for inflammation. Multivariable logistic/linear models were used to examine the associations of 25(OH)D with inflammation, iron status, hepcidin, and anemia.

Results: Approximately 50% of subjects were inflamed (C-reactive protein >5 mg/L or α-1-acid glycoprotein >1 g/L). Iron deficiency prevalence (inflammation-corrected ferritin <15 μg/L or soluble transferrin receptor >8.3 mg/L) was 67%; anemia was 36%, and vitamin D insufficiency (25(OH)D <30 ng/mL) was 77%. In linear regression models, vitamin D insufficiency was associated with increased hepcidin levels (β [SE] = 0.6 [0.2], P = 0.01) and reduced hemoglobin (β [SE] = -0.9 [0.5], P = 0.046), controlling for age, sex, race, insurance status, body mass index for age, inflammation, disease diagnosis (ulcerative colitis versus Crohn's disease), and disease duration, compared with 25(OH)D ≥30 ng/mL.

Conclusions: Our results suggest that concentrations of 25(OH)D ≥30 ng/mL are associated with lower hepcidin and higher hemoglobin levels. Further research is needed to clarify the association of vitamin D with inflammation, iron status, and anemia in pediatric IBD.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement for all authors:

SS: None relevant to this publication

ESM: None relevant to this publication

VT: None relevant to this publication

SC: None relevant to this publication

AK: None relevant to this publication

JP: None relevant to this publication

TRZ: None relevant to this publication

PSS: None relevant to this publication

SK: None relevant to this publication

Figures

Figure 1
Figure 1
Flow of Study Participants during six month enrollment period from May 2014 to November 2014
Figure 2
Figure 2. Hemoglobin (A) and hepcidin (B) concentrations with corresponding 95% confidence intervals, by 25(OH)D concentration
Panel A shows least squares mean hemoglobin concentration controlling for age, sex, race, Medicaid status, BAZ, inflammation, and disease duration, by 25(OH)D concentration. Those with 25(OH)D concentrations < 30 ng/mL had significantly lower hemoglobin concentrations compared to those with 25(OH)D concentrations ≥30 ng/mL (P=0.03). Panel B show the geometric mean hepcidin concentrations controlling for age, sex, race, Medicaid status, BAZ, inflammation, and disease duration, by 25(OH)D concentration. Those with 25(OH)D concentrations < 30 ng/mL had significantly higher serum hepcidin concentrations compared to those with 25(OH)D concentrations ≥ 30 ng/mL (P=0.01). *P<0.05
See this image and copyright information in PMC

References

    1. Abraham C, Cho JH. Inflammatory bowel disease. The New England journal of medicine. 2009;361(21):2066–78. - PMC - PubMed
    1. Rabizadeh S, Dubinsky M. Update in pediatric inflammatory bowel disease. Rheumatic diseases clinics of North America. 2013;39(4):789–99. - PMC - PubMed
    1. Conklin LS, Oliva-Hemker M. Nutritional considerations in pediatric inflammatory bowel disease. Expert review of gastroenterology & hepatology. 2010;4(3):305–17. - PubMed
    1. Sjoberg D, Holmstrom T, Larsson M, Nielsen AL, Holmquist L, Ronnblom A. Anemia in a population-based IBD cohort (ICURE): still high prevalence after 1 year, especially among pediatric patients. Inflammatory bowel diseases. 2014;20(12):2266–70. - PubMed
    1. Gerasimidis K, Barclay A, Papangelou A, Missiou D, Buchanan E, Tracey C, et al. The epidemiology of anemia in pediatric inflammatory bowel disease: prevalence and associated factors at diagnosis and follow-up and the impact of exclusive enteral nutrition. Inflammatory bowel diseases. 2013;19(11):2411–22. - PubMed

MeSH terms

Supplementary concepts