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The effects of two vitamin D regimens on ulcerative colitis activity index, quality of life and oxidant/anti-oxidant status.
Karimi, S, Tabataba-Vakili, S, Yari, Z, Alborzi, F, Hedayati, M, Ebrahimi-Daryani, N, Hekmatdoost, A
Nutrition journal. 2019;18(1):16
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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.
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The Effect of Serum 25-Hydroxyvitamin D on Serum Ferritin Concentrations: A Longitudinal Study of Participants of a Preventive Health Program.
Munasinghe, LL, Ekwaru, JP, Mastroeni, SSBS, Mastroeni, MF, Veugelers, PJ
Nutrients. 2019;11(3)
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Serum ferritin (SF) is the storage form of iron in the body. SF has been shown to increase as part of the body’s response to inflammation, and is therefore recognised as a marker of inflammation. Vitamin D has a key function in bone metabolism and is increasingly recognised for its anti-inflammatory effect. This longitudinal study looked at the association of serum 25-hydroxyvitamin D (25(OH)D) with levels of SF concentrations, and examined whether changes in serum 25(OH)D concentrations over time were accompanied by a change in SF concentrations. The study analysed data from 6812 Canadian adults who participated in a preventative health program. Just under half the participants were taking vitamin D supplements at a dose of 2000-5000iU per day. Measurements were taken at the start of the study, and at follow-up, which was an average of 12 months later. 25(OH)D levels at baseline were grouped into categories: <50nmol/L, 50 to <75nmol/L, 75 to <100nmol/L, 100 to <125nmol/L and >125nmol/L. During the follow-up, 25(OH)D concentrations increased from 80.7 to 115.0 nmol/L whereas SF concentrations decreased from 122.0 to 92.0 µg/L. Compared to participants with very low 25(OH)D concentrations of <50 nmol/L, those with concentrations of 75 to <100, 100 to <125, and ≥125 nmol/L had SF levels that were 13.00, 23.15, and 27.59 µg/L lower respectively (p < 0.001). Participants who improved their 25(OH)D levels by ≥50 nmol/L over the study period, decreased their SF concentrations by an average of 5.71 µg/L. The authors concluded that interventions aiming to lower SF concentrations through sun-exposure and vitamin D supplementation should aim for increases in 25(OH)D concentrations of at least 50nmol/L. Intervention studies are needed to further establish the beneficial effects of vitamin D on inflammation and cardiovascular health.
Abstract
Various studies have suggested a role of vitamin D in inflammation. However, its effect on ferritin, a biomarker of inflammation, has received relatively little attention. Therefore, we aimed to assess the association of serum 25-hydroxyvitamin D (25(OH)D) with serum ferritin (SF) concentrations, and to examine whether temporal increases in serum 25(OH)D concentrations are paralleled by a reduction in SF concentrations. Data from a community sample of Canadian adults who participated in a preventive health program (n = 6812) were analyzed. During the follow-up, serum 25(OH)D concentrations increased from 80.7 to 115.0 nmol/L whereas SF concentrations decreased from 122.0 to 92.0 µg/L (median follow-up time was 11.67 months). Cross-sectional analyses revealed that compared to participants with 25(OH)D concentrations of <50 nmol/L, those with 25(OH)D concentrations of 75 to <100, 100 to <125, and ≥125 nmol/L had SF concentrations that were 13.00, 23.15, and 27.59 µg/L lower respectively (p < 0.001). Compared to those without temporal improvements in 25(OH)D concentrations between baseline and follow-up, participants who improved their 25(OH)D concentrations with ≥50 nmol/L decreased their SF concentrations with 5.71 µg/L. For participants for whom the increase in 25(OH)D concentrations was less than 50 nmol/L, decreases in SF concentrations were less pronounced and not statistically significant. These observations suggest that despite strong associations between 25(OH)D and SF concentrations, interventions aiming to lower SF concentrations through sun-exposure and vitamin D supplementation should target substantial increases in 25(OH)D concentrations.