Digestion. 2021 Feb 8;1-9. doi: 10.1159/000513589. Online ahead of print.

Akihiro Yamada ^1 2, Yuga Komaki ^1 3, Fukiko Komaki ^1 3, Haider Haider ¹, Dejan Micic ¹, Joel Pekow ¹, Sushila Dalal ¹, Russell D Cohen ¹, Lisa Cannon ^1 4, Konstantin Umanskiy ^1 4, Radhika Smith ^1 4, Benjamin D Shogan ^1 4, Roger Hurst ^1 4, Neil Hyman ^1 4, David T Rubin ¹, Atsushi Sakuraba ⁵

Author information

• ¹Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA.
• ²Section of Gastroenterology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, Japan.
• ³Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
• ⁴Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA.
• ⁵Inflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, Illinois, USA, asakurab@medicine.bsd.uchicago.edu.

Abstract

Background and aims: Vitamin D deficiency has been associated with disease activity in Crohn's disease (CD). We assessed whether there is a correlation between vitamin D levels and the risk of postoperative recurrence in CD.

Methods: CD patients who underwent surgery were identified from a prospectively maintained database at the University of Chicago. The primary endpoint was the correlation of serum 25-hydroxy vitamin D levels measured at 6-12 months after surgery and the proportion of patients in endoscopic remission, defined as a simple endoscopic score for CD of 0. Clinical, biological (C-reactive protein), and histologic recurrences were also studied.

Results: Among a total of 89 patients, 17, 46, and 26 patients had vitamin D levels of <15, 15-30, and >30 ng/mL, respectively. Patients with higher vitamin D levels were significantly more likely to be in endoscopic remission compared to those with lower levels (23, 42, and 67% in ascending tertile order; p = 0.028). On multivariate analysis, vitamin D >30 ng/mL (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.07-0.66, p = 0.006) and anti-tumor necrosis factor agent treatment (OR 0.25, 95% CI 0.08-0.83, p = 0.01) were associated with reduced risk of endoscopic recurrence. Rates of clinical, biological, and histologic remission trended to be higher in patients with higher vitamin D levels (p = 0.17, 0.55, 0.062, respectively).

Conclusion: In the present study, higher vitamin D level was associated with lower risk of postoperative endoscopic CD recurrence. Further, studies are warranted to assess the role of vitamin D in postoperative CD recurrence.