Results of a randomized, double-blind, clinical trial showed children with inflammatory bowel disease (IBD) appear to benefit from supplementation with vitamin D. These findings were published in the Journal of Clinical Gastroenterology.
Patients (N=98) with IBD aged 5 to 18 years were recruited between 2017 and 2018 from the pediatric and gastroenterology departments of Tanta University in Egypt. All children had low (<20 ng/mL) baseline vitamin D levels. Patients were randomly assigned to receive 2000 IU/day oral vitamin D3 (n=50) or placebo (n=48) for 6 months. The effect of vitamin D supplementation on IBD activity score and quality of life (QOL) were assessed.
The intervention and control cohorts were aged mean 13.4±1.2 and 13±1.6 years, the girl:boy ratio was 29:21 and 26:24, 54% and 54.2% had Crohn disease (CD), IBD duration was 3.3±1.3 and 3.21±1.4 years, and serum vitamin D levels were 13.4±2.7 and 14.5±3.2 ng/mL, respectively.
At 6 months, supplementation was associated with increased serum vitamin D and interleukin (IL)-10 (both P =.001) and significantly decreased erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fecal calprotectin, tumor necrosis factor-a (TNF-a), IL-17, IL-12, and IL-23 (all P =.001) concentrations compared with placebo.
Among the supplement and placebo cohorts, 8% and 33.3% had active disease (P =.02), 16% and 37.5% had relapsed (P =.001), 12% and 31.3% had visited the emergency department (P =.01), and 10% and 27.1% had been hospitalized (P =.02), respectively.
The vitamin D supplementation decreased Pediatric CD Activity Index (mean, 13.6 vs 27.5; P =.001) and Pediatric Ulcerative Colitis Activity Index (mean, 11 vs 21.8; P =.001) and increased QOL scores (mean, 159.9 vs 119.2; P =.01).
Serum vitamin D levels were significantly negatively correlated with inflammatory markers ESR, CRP, fecal calprotectin, TNF-a, IL-12, IL-17, and IL-23, as well as with IBD activity score, emergency department visit, and hospitalization frequency (all P £.03).
This study was limited by including only a single treatment dose and schedule. Additional study is needed to assess which dose best improves IBD symptoms and QOL.
These data indicated that pediatric patients with IBD may benefit from supplementation with vitamin D, improving disease symptoms and QOL.
El Amrousy D, El Ashry H, Hodeib H, Hassan S. Vitamin D in children with inflammatory bowel disease: a randomized controlled clinical trial. J Clin Gastroenterol. 2021;55(9):815-820. doi:10.1097/MCG.0000000000001443