Fat-soluble vitamin levels generally lower in IBD patients
Patients with inflammatory bowel disease (IBD) appear to have deficiencies in fat-soluble vitamins, according to a systematic review and meta-analysis. Such deficiency highlights the need for supplementation in this population.
Researchers conducted a meta-regression analysis of 19 case-control studies evaluating the serum concentrations of fat-soluble vitamin levels in IBD patients vs healthy individuals. They identified pooled mean differences (MDs) between groups and estimated their associations with several compounding variables (age, disease duration, C-reactive protein and albumin).
Results revealed that patients with Crohn’s disease (CD) had lower levels of vitamins A (MD, 212.92 µg/L; p=0.0002), D (MD, 6.97 nmol/L; p=0.01), E (MD, 4.72 µmol/L; p=0.003) and K (MD, 1.46 ng/mL; p=0.003) compared with controls. CD patients with longer disease duration showed even lower levels of vitamins A and K (p=0.02 for both).
Similarly, patients with ulcerative colitis had lower levels of vitamin A relative to controls (MD, 223.22 µg/L; p=0.01).
Statistically significant associations were found between the levels of inflammatory biomarkers (C-reactive protein, p=0.03; albumin, p=0.0003) and vitamin A status among CD patients.
The present data highlight the need to encourage clinicians to re-evaluate the inclusion of vitamin supplementation and for further research in the field, researchers said, adding that the decreased vitamin levels often observed in IBD patients is multifactorial.
First, patients with IBD tend to avoid food due to exacerbation of the abdominal pain. Second, the presence of ulcerations or small bowel resection may reduce the intestinal absorptive surface, which can also lead to decreased vitamin levels. Finally, vitamin deficiencies may be caused by an excessive intestinal loss, effect of medical therapy or exclusive parenteral nutrition without administration of proper supplements.