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. 2023 Dec 5;101(12):907-911.

Prevalence and risk factors for vitamin D deficiency in Crohn disease patients: A Tunisian study

[Article in French]
Shema Ayadi  1   2 , Myriam Ayari  1   2 , Afef Bahlous  3   2 , Yosra Zaimi  1   2 , Emna Bel Hadj Mabrouk  1   4 , Leila Mouelhi  1   4 , Radhouane Debbeche  1   4
Affiliations

Prevalence and risk factors for vitamin D deficiency in Crohn disease patients: A Tunisian study

[Article in French]
Shema Ayadi et al. Tunis Med. .

Abstract
in English, French

Introduction: Vitamin D plays a role in regulating the immune response through an immunomodulatory effect, and is probably involved in the pathophysiology of Crohn's disease (CD).

Aim: to assess vitamin D status in patients with CD as well as in healthy controls and to determine associated factors of vitamin D deficiency in patients with CD.

Methods: We conducted a prospective study over 18 months, including CD patients with age and sex matched with healthy controls. Suboptimal vitamin D status was defined by vitamin D serum level < 30 ng/ml, vitamin insufficiency by vitamin D serum level between 10 and 30 ng/ml and vitamin deficiency serum level < 10 ng/ml.

Results: We included 77 subjects (52 patients with CD and 25 controls) with mean age of 38 years± 11. Most patients and controls had suboptimal levels of vitamin D (98% and 96% respectively) including vitamin D deficiency in 75% and 67%, respectively and vitamin D insufficiency in 25% and 33%, respectively. In univariate analysis, vitamin D deficiency was associated with disease flare-up (p=0.001), anemia (p=0.002), hypo-albuminemia (p=0.002), elevated C-reactive protein (CRP) (p=0.003), Crohn's Disease Activity Index (CDAI) (p<0.001), ileal location (p=0.04) and immunosuppressive therapy (p=0.01). In multivariate analysis, only CDAI was significantly associated with vitamin D deficiency (p=0.003, OR=9.33).

Conclusion: Vitamin D deficiency is common in Tunisian CD patients as well as in controls and is associated with disease activity.

Introduction: La vitamine D joue un rôle immunomodulateur au cours de la réponse immunitaire et interviendrait probablement dans la physiopathologie de la maladie de Crohn (MC).Objectif: Evaluer le statut en vitamine D chez les patients atteints de la MC et chez les témoins sains, et déterminer les facteurs associés à la carence en vitamine D. Méthodes: Etude prospective sur 18 mois, incluant des patients atteints de MC et des témoins sains appariés selon l’âge et le sexe. Le déficit en vitamine D était défini par des taux sériques de 25OHD inférieurs à 30 ng/ml et subdivisé en : insuffisance vitaminique : 10 ng/ml < 25(OH)D < 30 ng/ml et carence vitaminique : 25(OH)D < 10 ng/ml.Résultats: Nous avons inclus 77 sujets (52 patients avec MC et 25 témoins) d’âge moyen de 38 ans± 11. Le déficit en vitamine D était fréquent chez les patients et les témoins (98% et 96% respectivement), représenté principalement par une carence vitaminique (75% et 67%, respectivement). En analyse univariée, la carence vitaminique était associée à une MC en poussée (p=0,001), à l’anémie (p=0,002), à l’hypoalbuminémie (p=0,002), à une protéine C-réactive élevée (p=0,003), à l’indice d’activité de la MC(CDAI) (p<0,001), à l’atteinte iléale (p=0,04) et au traitement immunosuppresseur (p=0,01). En analyse multivariée, seul le CDAI était significativement associé à la carence en vitamine D (p=0,003, OR=9,33).Conclusion: La carence en vitamine D était fréquente chez les patients tunisiens atteints de MC et associée à l’activité de la maladie.

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