Vitamin D in inflammatory bowel disease: more than just a supplement

Curr Opin Gastroenterol. 2018 Jul;34(4):217-225. doi: 10.1097/MOG.0000000000000449.

Abstract

Purpose of review: The aim of this review is to explore the protective role of vitamin D on the gastrointestinal tract, summarize the epidemiology of vitamin D deficiency in inflammatory bowel disease (IBD), and highlight recent studies examining the impact of low vitamin D and vitamin D supplementation on IBD clinical outcomes.

Recent findings: Vitamin D protects the gut barrier by regulating tight junction proteins and inhibiting intestinal apoptosis. Vitamin D enhances innate immunity by inducing antimicrobial peptides and regulates adaptive immunity by promoting anti-inflammatory T cells and cytokines. Vitamin D may also alter the gut microbiota. The prevalence of vitamin D deficiency in IBD is 30-40%. Predictors of vitamin D deficiency in IBD include non-white ethnicity, IBD-related surgery, BMI more than 30, female sex, and pregnancy. Low vitamin D is associated with increased disease activity, inflammation, and clinical relapse. The effect of vitamin D supplementation on IBD clinical outcomes is inconclusive.

Summary: Vitamin D plays a protective role on gut health. Vitamin D deficiency in IBD is prevalent and associated with poor outcomes. The benefits of vitamin D supplementation in IBD is unclear. Measuring novel vitamin D metabolites and vitamin D absorption in IBD patients may help guide future studies.

Publication types

  • Review

MeSH terms

  • Dietary Supplements*
  • Gastrointestinal Microbiome / drug effects
  • Humans
  • Immunity, Innate / drug effects
  • Inflammation / complications
  • Inflammation / diet therapy
  • Inflammation / immunology
  • Inflammatory Bowel Diseases / complications*
  • Inflammatory Bowel Diseases / diet therapy*
  • Inflammatory Bowel Diseases / physiopathology
  • Intestinal Absorption / drug effects
  • Observational Studies as Topic
  • Vitamin D / metabolism*
  • Vitamin D / pharmacology
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / complications*
  • Vitamin D Deficiency / physiopathology
  • Vitamins / metabolism
  • Vitamins / pharmacology
  • Vitamins / therapeutic use*

Substances

  • Vitamins
  • Vitamin D