Vitamin D possesses anti-inflammatory properties and could be beneficial in ulcerative colitis (UC). According to a study published in the Journal of Clinical Gastroenterology, supplementation with oral nano vitamin D significantly reduces inflammatory markers of UC, including C-reactive protein (CRP) values.

In this single-center, double-blind, randomized, parallel, placebo-controlled trial with concealed allocation from November 2016 to May 2017Fesr, patients with active UC and vitamin D deficiency (N=60) were randomized into a vitamin D supplementation group (60,000 IU daily) (n=30) or a placebo group that received a similar-looking and tasting syrup from a similar container for 8 days (n=30). The primary outcome was the clinical response, defined as a reduction of ≥3 points in the UC disease activity index (UCDAI) score from the baseline value at 4 weeks. The secondary outcome response measures were reduction in stool frequency by >2/day, improvement in stool consistency by >2 points, remission defined as a UCDAI score <3 at 4 weeks, reduction of fecal calprotectin levels by 50 units, and serum markers of inflammation.

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The 3-point reduction in UCDAI score occurred more often in the group receiving vitamin D compared with the placebo cohort (n=16/30 [53.3%] vs n=4/30 [13.3%]; P =.002). Disease severity was also significantly reduced in the vitamin D group compared with the placebo group (n=18/30 [60%] vs n=10/30 [33%]; P =.038). The vitamin D group also had more reduction in stool frequency, improved stool consistency, and fecal calprotectin, as well as lower UCDAI scores compared with controls (5 vs 7; P =.075). The pre-intervention and post-intervention vitamin D levels were significantly correlated with baseline and post-treatment UCDAI scores, respectively (ρ=-0.274; P =.034 and ρ=-0.455; P ≤.001). Additionally, the increase in vitamin D levels demonstrated significant correlation with decrease in UCDAI (Pearson’s correlation, ρ= −0.713, P ≤0.001), decrease in erythrocyte sedimentation rate (ρ=−0.256, P=0.049), decrease in CRP (ρ=−0.598, P≤0.001), decrease in calprotectin (ρ=−0.368, P=0.004), and decrease in histology score (ρ=−0.608, P≤0.001).


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Limitations of this study include the relatively small sample size and a short follow-up period of 1 month, in which none of the patients achieved remission. Patients with acute severe colitis requiring hospitalization were excluded. Logistic constraints prevented long-term follow-up of patients to assess relapse.

There was a significant improvement with supplementation of vitamin D in all inflammatory parameters, including clinical, endoscopic, histopathologic, and serum and fecal markers of inflammation. Future research could examine the pharmacokinetics of nano vitamin D in patients with inflammatory bowel disease.

Reference

Ahamed R, Dutta U, Sharma V, et al. Oral nano vitamin D supplementation reduces disease activity in ulcerative colitis: a double-blind randomized parallel group placebo-controlled trial [published online July 26, 2019]. Clin Gastroenterol. doi: 10.1097/MCG.0000000000001233