Vitamine D bij darm- en leverontstekingen?*
Uit twee nieuwe studies blijkt dat mensen met een chronische darmontsteking zoals de ziekte van
Crohn en colitis ulcerosa een verhoogd risico hebben op een
vitamine D tekort.
Uit de ene studie blijkt dat 50% van de mensen met de chronische darmontstekingen te lage bloedwaarden vitamine D heeft en 11% heeft duidelijk te lage waarden. De mensen met te weinig vitamine D blijken ook duidelijk meer ontstekingen te hebben dan zij met goede bloedwaarden vitamine D. Bij mensen met de ziekte van Crohn en lage bloedwaarden vitamine D verslechterde ook duidelijk de kwaliteit van het leven.
Uit de andere studie blijkt dat ruim 92% van de mensen met een chronische leverontsteking zoals
hepatitis C al dan niet met cirrose of alleen cirrose in meer of mindere mate een tekort hebben aan vitamine D. Minstens 1/3 van deze mensen heeft een flink tekort (< 7ng/ml). Zonder aanvullingen leiden deze tekorten tot botontkalking en osteoporose bij deze patiënten.
Vitamin D Deficiency Common In Patients With IBD, Chronic Liver Disease
Vitamin D replacement may be necessary to reverse deficiency-related bone loss
New research presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando found patients with inflammatory bowel disease or chronic liver disease were at increased risk of developing Vitamin D deficiencies. Two separate studies highlight the importance of regular Vitamin D checkups in the evaluation of patients with certain digestive diseases.
For IBD Patients, Vitamin D Deficiency Associated with Lower Quality of Life and Higher Disease Activity
Researchers at the Medical College of Wisconsin investigated whether Vitamin D deficiency in patients with IBD is associated with a lower quality of life or higher disease activity independent of other known risk factors and medication use.
Disease activity and quality of life were assessed using validated questionnaires, which were administered at every clinic visit. The researchers also looked at the prevalence and seasonality of Vitamin D deficiency in this inflammatory bowel disease population, as well as its association with IBD-related hospitalizations, surgeries and medication use.
This retrospective cohort study conducted by Dr. Alex Ulitsky and his colleagues analyzed vitamin D levels of 504 inflammatory bowel disease patients. They recorded the patients' lowest Vitamin D measurements and date when each low measurement was taken.
Dr. Ulitsky and his team found almost 50 percent of the patients were Vitamin D deficient at some point, with 11 percent being severely deficient. Vitamin D deficiency was not significantly associated with being hospitalized for IBD or having IBD-related surgeries. However, in both Crohn's disease (CD) and ulcerative colitis (UC) patients, vitamin D deficiency was independently associated with having increased disease activity scores compared to those with normal levels of Vitamin D. Vitamin D deficient CD patients, but not UC patients, had worse quality of life when compared to patients who were not Vitamin D deficient.
According to Dr. Ulitsky, "All IBD patients, irrespective of their disease, disease location or nature should have their Vitamin D levels checked regularly and corrected aggressively when insufficiency is found."
Vitamin D Deficiency Prevalent in Patients with Chronic Liver Disease
Researchers from the University of Tennessee in Memphis measured the vitamin D levels of 118 chronic liver disease patients. Researchers found 92.4 percent of chronic liver patients had some degree of vitamin D deficiency and at least one third were severely deficient. Severe vitamin D deficiency was more common among cirrhotics.
"Since deficiency is common among these patients, Vitamin D replacement may hopefully prevent osteoporosis and other bone complications related to end stage liver disease," said lead researcher Dr. Satheesh P.
Nair.
The study included 43 hepatitis C patients with cirrhosis; 57 hepatitis C patients without cirrhosis; 18 cirrhosis patients without hepatitis C. The severity of vitamin D deficiency was divided into three groups: mild (between 20-32 ng/ml), moderate (between 7-20 ng/ml), and severe (less than 7 ng/ml).
Importance of Vitamin D and Bone Health
Vitamin D, a fat-soluble vitamin, helps the body absorb calcium and plays a crucial role in the growth and maintenance of strong, healthy bones. A lack of vitamin D causes calcium-depleted bone, which can weaken the bones and increase the risk of fractures resulting from
osteoporosis.
A diet rich in vitamin D, such as fish, eggs, fortified milk, and cod liver oil, is essential to maintaining good bone health.
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an organization with an international membership of more than 10,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist through its emphasis on scholarly practice, teaching and research. The mission of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically sound, humanistic, ethical, and cost-effective health care to gastroenterology
patients.
The ACG is committed to providing accurate, unbiased and up-to-date health information. Visit the ACG Web site http://www.acg.gi.org/ to access educational resources for patients and their families spanning the broad range of digestive diseases and conditions - both common and not-so-common. Organized by disease, state and organ system, these educational materials, developed by ACG physician experts, are offered for the information and benefit of patients and the public.
American College of Gastroenterology (December
2008)
