P169 Vitamin D levels are inversely associated with inflammation in pediatric InflammatoryBowel Disease patients

Abstract

Abstract Background Multiple pathways link Vitamin D status with the risk of development and the clinical course of Inflammatory Bowel Disease (IBD). However, limited studies have been conducted on the relationship between vitamin D and disease activity in IBD, especially in pediatric population and the results have been inconsistent. Moreover Vitamin D metabolites may provide a more precise assessment of sufficiency and mineral metabolism than total 25-hydroxyvitamin-D (25(OH)D). The aim of our study was to evaluate the concentrations of total25(OH)D, 24,25-dihydroxyvitamin D (24,25(OH)2D) and calcitriol (1,25-(OH)2D) to correlate these values with the disease activity markers. Methods We prospectively enrolled all IBD pediatric patients. Total 25(OH)D, 24,25(OH)2D and1,25-(OH)2D levels were measured by enzyme-linked immunosorbent assay (ELISA). In each patient with IBD, the activity scores of disease and the main inflammation markers were correlated to Vitamin D metabolites. We prospectively enrolled all IBD pediatric patients. Total 25(OH)D, 24,25(OH)2D and1,25-(OH)2D levels were measured by enzyme-linked immunosorbent assay (ELISA). In each patient with IBD, the activity scores of disease and the main inflammation markers were correlated to Vitamin D metabolites. Results One hundred twenty three consecutive IBD children were enrolled, 43% with Crohn Disease (CD),55% Ulcerative colitis (UC), 2% indeterminate colitis. No difference in 25(OH)D,24,25(OH)2D and 1,25-(OH)2D levels were found between CD and UC patients. A significant indirect correlation was found between C reactive protein and 1,25-(OH)2D levels in patients with IBD (r=-0.275, p=0.046) and in CD group (r=-0.477, p=0.039). Moreover, in patients with IBD and CD we found a significant indirect correlation between erythrocyte sedimentation rate(ESR) and 25(OH)D (r=-0.212, p=0.024 and and r=-0.282, p=0.047 respectively). Instead, in the UC group we found only a direct correlation for both fibrinogen and ESR with 1,25-(OH)2Dlevels (r=0.407, p 0.028 and r=0.446, p=0.013). Conclusion Our results suggest that both the active form and the total Vitamin D levels are inversely associated with disease activity especially in CD children. Further studies are needed to clarify the role of Vitamin D deficiency as a consequence or a cause of inflammation.