The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status.

Nutrition journal. 2019;18(1):16
Full text from:

Plain language summary

Ulcerative colitis (UC) is a type of Inflammatory bowel disease (IBD), which involves the immune system attacking healthy bowel tissue. Vitamin D has an effect on the immune response, possibly by reducing inflammation, promoting immune system tolerance and improving the health of the bowel lining. Several studies have found a link between vitamin D deficiency and IBD, but the optimum dosage for vitamin D supplementation is not yet known. The aim of this study was to look at the effects of two dosages of vitamin D supplementation on serum vitamin D, total antioxidant capacity (TAC), total oxidant status (TOS), quality of life, and disease activity index in patients with UC. In this double blind randomised clinical trial, 50 patients with mild to moderate UC received either 1,000 (‘low dose’) or 2,000 (‘high dose’) IU/day of vitamin D for 12 weeks. At the end of study, serum 25-OHD levels had significantly increased in the high dose group and the increase was significantly more (6.7 ± 3.8 ng/mL) than the low dose (0.2 ± 0.5 ng/mL) group. Serum TOS concentration decreased significantly (- 0.37 ± 0.26) only in the high dose group. There was no significant change in serum TAC between two groups during the study. The quality of life score significantly improved in the high dose group compared to the low dose group and disease activity index score reduce in both groups but was significant only in the high dose group. The authors concluded that 2,000 IU a day of vitamin D can increase serum 25-OHD concentration and quality of life, and reduce disease activity in UC patients with vitamin D deficiency. They recommend that all patients with UC should have their vitamin D status assessed because they may benefit from vitamin D therapy.

Abstract

BACKGROUND The optimum dosage for vitamin D supplementation has not yet been elucidated in patients with Ulcerative colitis (UC). The aim of this study was to investigate the effects of two vitamin D regimens in UC patients with vitamin D deficiency. METHODS In this double blind randomized clinical trial, 50 patients with mild to moderate UC, who met inclusion criteria, received either 1000 or 2000 IU/day of vitamin D (as low dose or high dose group, respectively) for 12 weeks. Serum 25-hydroxy vitamin D (25-OHD) level, total antioxidant capacity (TAC), and Total Oxidant Status (TOS), the inflammatory bowel disease questionnaire - 9 (IBDQ-9) score and the Simple Clinical Colitis Activity Index Questionnaire (SCCAI) score were assessed before and after intervention. RESULTS At the end of study, serum 25-OHD levels significantly increased in the high dose group (P < 0.001) and the increase was significantly more than low dose group (6.7 ± 3.8 ng/mL in the high dose group versus 0.2 ± 0.5 ng/mL in the low dose group) (P < 0.001). Serum TOS concentration decreased significantly (- 0.37 ± 0.26) only in the high dose group (P value = 0.023). There was no statistically significant change in serum TAC between two groups during the study. IBDQ-9 mean score significantly increased in high dose group compared to the low dose group (P value = 0.001) and SCCAI score in both groups reduced (- 2.58 ± 2.16 and - 0.9 ± 0.3 in high dose and low dose respectively), while this reduction was significant only in the high dose group (P value ≥0.001). CONCLUSION Our results indicate that 2000 IU daily dose of vitamin D can increase serum 25-OHD concentration, and quality of life, while it reduces disease activity in UC patients with vitamin D deficiency. We recommend assessment of the vitamin D status in all patients with UC because they may benefit from vitamin D therapy.

Lifestyle medicine

Fundamental Clinical Imbalances : Immune and inflammation
Patient Centred Factors : Mediators/Vitamin D
Environmental Inputs : Nutrients
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Blood

Methodological quality

Jadad score : 4
Allocation concealment : Yes
Publication Type : Journal Article

Metadata

Nutrition Evidence keywords : Antioxidants ; Autoimmunity