Circulating 25-hydroxyvitamin D concentration can predict bowel resection risk among individuals with inflammatory bowel disease in a longitudinal cohort with 13 years of follow-up.
Int J Surg
; 110(7): 4275-4285, 2024 Jul 01.
Article
em En
| MEDLINE
| ID: mdl-38526503
ABSTRACT
BACKGROUND:
Although the beneficial properties of vitamin D in anti-inflammation and immunity-modulation are promising in the management of inflammatory bowel disease (IBD), data were limited for the critical IBD prognosis. The association between serum vitamin D levels and the risk of bowel resection in individuals with IBD remains largely unknown. MATERIALS ANDMETHODS:
The authors performed a longitudinal cohort study among 5474 individuals with IBD in the UK Biobank. Serum 25-hydroxyvitamin D [25(OH)D] was measured using direct competitive chemiluminescent immunoassay. Bowel resection events were ascertained via national inpatient data. Multivariable-adjusted Cox proportional hazard regression was used to examine the association between serum 25(OH)D and bowel resection risk, presented with hazard ratios (HRs) and 95% CIs. Restricted cubic spline (RCS) was used to evaluate dose-response associations.RESULTS:
During a mean follow-up of 13.1 years, the authors documented 513 incident bowel resection cases. Compared to participants with vitamin D deficiency, nondeficient participants showed a significantly reduced bowel resection risk in IBD (HR 0.72, 95% CI 0.59-0.87, P =0.001), Crohn's disease (CD, HR 0.74, 95% CI 0.56-0.98, P =0.038), and ulcerative colitis (UC, HR 0.73, 95% CI 0.57-0.95, P =0.020). When comparing extreme quintiles of 25(OH)D level, participants with IBD showed a 34% reduced risk of bowel resection (95% CI 11-51%, P =0.007) and participants with UC showed a 46% reduced risk (95% CI 19-64%, P =0.003), while this association was not significant in CD (HR 0.93, 95% CI 0.59-1.45, P =0.740). Linear dose-response associations were observed using the RCS curve (all P -nonlinearity>0.05).CONCLUSION:
Increased serum level of 25(OH)D is independently associated with reduced bowel resection risk in IBD. This association was significant in UC but may not be stable in CD. Vitamin D deficiency is a risk factor for bowel resection in individuals with IBD, and may be an effective metric in predicting and risk-screening surgical events.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Vitamina D
/
Doenças Inflamatórias Intestinais
Limite:
Adult
/
Aged
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Int J Surg
/
Int. j. surg
/
International journal of surgery
Ano de publicação:
2024
Tipo de documento:
Article