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Published in: European Journal of Nutrition 1/2022

01-02-2022 | Ulcerative Colitis | Review

Effects of vitamin D supplementation on blood markers in ulcerative colitis patients: a systematic review and meta-analysis

Authors: Yuanyuan Guan, Yang Hao, Yun Guan, Huaien Bu, Hongwu Wang

Published in: European Journal of Nutrition | Issue 1/2022

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Abstract

Objective

Observational studies have shown that vitamin D levels are inversely related to ulcerative colitis activity, yet evidence from population interventions remains inconsistent. We conducted a systematic review and meta-analysis of randomized-controlled trials to clarify the effect of vitamin D on blood markers in patients with ulcerative colitis.

Methods

The PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases were searched for studies published before June 2020. Information was collected regarding serum vitamin D levels, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), and Ca (calcium), and parathyroid hormone (PTH), and ulcerative colitis disease activity index (UCDAI) research data.

Results

Seven studies (n = 539) were included in the meta-analysis. Vitamin D supplementation resulted in significant improvements in the serum vitamin D levels (standardized mean difference (SMD) = 0.69, 95% CI (0.36, 1.03), P < 0.001), ESR (weighted mean difference (WMD) = − 1.10, 95% CI (− 1.97, − 0.24), P = 0.01), CRP (SMD = − 0.43, 95% CI (− 0.67, − 0.20), P = 0.0003), and Ca (SMD = 0.92, 95% CI (0.09, 1.74), P = 0.03) but not in other outcomes. According to subgroup analysis, supplementation with vitamin D at a dose of ≥ 300,000 IU/day can improve serum vitamin D levels. Supplementation with a sufficient dose of vitamin D in a short period of time can also improve serum vitamin D levels. According to GRADE method evaluation, the evidence quality was classified as low for the Serum Vitamin D Level and ESR, and very low for the CRP, PTH, Ca, and UCDAI.

Conclusions

Compared with placebo control interventions, vitamin D supplementation seemed to be an effective intervention for patients with ulcerative colitis. Different doses of vitamin D and durations of intervention produce different effects. However, due to the limitation of the quality of the included studies, the above conclusions still need to be verified by more high-quality studies and weak clinical recommendations.
Literature
2.
go back to reference Matsuoka K, Kobayashi T, Ueno F, Matsui T, Hirai F, Inoue N, Kato J, Kobayashi K, Kobayashi K, Koganei K, Kunisaki R, Motoya S, Nagahori M, Nakase H, Omata F, Saruta M, Watanabe T, Tanaka T, Kanai T, Noguchi Y, Takahashi KI, Watanabe K, Hibi T, Suzuki Y, Watanabe M, Sugano K, Shimosegawa T (2018) Evidence-based clinical practice guidelines for inflammatory bowel disease. J Gastroenterol 53(3):305–353. https://doi.org/10.1007/s00535-018-1439-1CrossRefPubMedPubMedCentral Matsuoka K, Kobayashi T, Ueno F, Matsui T, Hirai F, Inoue N, Kato J, Kobayashi K, Kobayashi K, Koganei K, Kunisaki R, Motoya S, Nagahori M, Nakase H, Omata F, Saruta M, Watanabe T, Tanaka T, Kanai T, Noguchi Y, Takahashi KI, Watanabe K, Hibi T, Suzuki Y, Watanabe M, Sugano K, Shimosegawa T (2018) Evidence-based clinical practice guidelines for inflammatory bowel disease. J Gastroenterol 53(3):305–353. https://​doi.​org/​10.​1007/​s00535-018-1439-1CrossRefPubMedPubMedCentral
4.
5.
go back to reference Lopez-Siles M, Enrich-Capo N, Aldeguer X, Sabat-Mir M, Duncan SH, Garcia-Gil LJ, Martinez-Medina M (2018) Alterations in the abundance and co-occurrence of akkermansia muciniphila and faecalibacterium prausnitzii in the colonic mucosa of inflammatory bowel disease subjects. Front Cell Infect Microbiol 8:16. https://doi.org/10.3389/fcimb.2018.00281CrossRef Lopez-Siles M, Enrich-Capo N, Aldeguer X, Sabat-Mir M, Duncan SH, Garcia-Gil LJ, Martinez-Medina M (2018) Alterations in the abundance and co-occurrence of akkermansia muciniphila and faecalibacterium prausnitzii in the colonic mucosa of inflammatory bowel disease subjects. Front Cell Infect Microbiol 8:16. https://​doi.​org/​10.​3389/​fcimb.​2018.​00281CrossRef
10.
go back to reference Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, Shoenfeld Y, Lerchbaum E, Llewellyn DJ, Kienreich K, Soni M (2013) Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality—a review of recent evidence. Autoimmun Rev 12(10):976–989. https://doi.org/10.1016/j.autrev.2013.02.004CrossRefPubMed Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, Shoenfeld Y, Lerchbaum E, Llewellyn DJ, Kienreich K, Soni M (2013) Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality—a review of recent evidence. Autoimmun Rev 12(10):976–989. https://​doi.​org/​10.​1016/​j.​autrev.​2013.​02.​004CrossRefPubMed
11.
go back to reference Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guérin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmun Rev 9(11):709–715. https://doi.org/10.1016/j.autrev.2010.06.009CrossRefPubMed Souberbielle JC, Body JJ, Lappe JM, Plebani M, Shoenfeld Y, Wang TJ, Bischoff-Ferrari HA, Cavalier E, Ebeling PR, Fardellone P, Gandini S, Gruson D, Guérin AP, Heickendorff L, Hollis BW, Ish-Shalom S, Jean G, von Landenberg P, Largura A, Olsson T, Pierrot-Deseilligny C, Pilz S, Tincani A, Valcour A, Zittermann A (2010) Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: recommendations for clinical practice. Autoimmun Rev 9(11):709–715. https://​doi.​org/​10.​1016/​j.​autrev.​2010.​06.​009CrossRefPubMed
12.
go back to reference Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, Povoroznyuk V, Balatska N, Barbosa AP, Karonova T, Rudenka E, Misiorowski W, Zakharova I, Rudenka A, Łukaszkiewicz J, Marcinowska-Suchowierska E, Łaszcz N, Abramowicz P, Bhattoa HP, Wimalawansa SJ (2018) Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol 175:125–135. https://doi.org/10.1016/j.jsbmb.2017.01.021CrossRefPubMed Pludowski P, Holick MF, Grant WB, Konstantynowicz J, Mascarenhas MR, Haq A, Povoroznyuk V, Balatska N, Barbosa AP, Karonova T, Rudenka E, Misiorowski W, Zakharova I, Rudenka A, Łukaszkiewicz J, Marcinowska-Suchowierska E, Łaszcz N, Abramowicz P, Bhattoa HP, Wimalawansa SJ (2018) Vitamin D supplementation guidelines. J Steroid Biochem Mol Biol 175:125–135. https://​doi.​org/​10.​1016/​j.​jsbmb.​2017.​01.​021CrossRefPubMed
13.
go back to reference Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930. https://doi.org/10.1210/jc.2011-0385CrossRef Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 96(7):1911–1930. https://​doi.​org/​10.​1210/​jc.​2011-0385CrossRef
23.
go back to reference Vrablicova Z, Soltys K, Krajcovicova A, Sturdik I, Koller T, Huorka M, Payer J, Stuchlik S, Killinger Z, Jackuliak P, Stuchlikova M, Drahovska H, Hlavaty T (2018) Influence of vitamin D on the expression of mRNA of cytokines in the mucosa of inflammatory bowel disease patients. Bratisl Lek Listy 119(7):408–415. https://doi.org/10.4149/bll_2018_074CrossRefPubMed Vrablicova Z, Soltys K, Krajcovicova A, Sturdik I, Koller T, Huorka M, Payer J, Stuchlik S, Killinger Z, Jackuliak P, Stuchlikova M, Drahovska H, Hlavaty T (2018) Influence of vitamin D on the expression of mRNA of cytokines in the mucosa of inflammatory bowel disease patients. Bratisl Lek Listy 119(7):408–415. https://​doi.​org/​10.​4149/​bll_​2018_​074CrossRefPubMed
30.
go back to reference Sharifi A, Vahedi H, Nedjat S, Rafiei H, Hosseinzadeh-Attar MJ (2019) Effect of single-dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebo-controlled trial. APMIS Acta Pathol Microbiol et Immunol Scand 127(10):681–687. https://doi.org/10.1111/apm.12982CrossRef Sharifi A, Vahedi H, Nedjat S, Rafiei H, Hosseinzadeh-Attar MJ (2019) Effect of single-dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebo-controlled trial. APMIS Acta Pathol Microbiol et Immunol Scand 127(10):681–687. https://​doi.​org/​10.​1111/​apm.​12982CrossRef
32.
34.
go back to reference Sharifi A, Vahedi H, Honarvar MR, Amiriani T, Nikniaz Z, Rad EY, Hosseinzadeh-Attar MJ (2020) Vitamin D decreases CD40L gene expression in ulcerative colitis patients: a randomized, double-blinded, placebo-controlled trial. Turk J Gastroenterol Off J Turk Soc Gastroenterol 31(2):99–104. https://doi.org/10.5152/tjg.2020.181028CrossRef Sharifi A, Vahedi H, Honarvar MR, Amiriani T, Nikniaz Z, Rad EY, Hosseinzadeh-Attar MJ (2020) Vitamin D decreases CD40L gene expression in ulcerative colitis patients: a randomized, double-blinded, placebo-controlled trial. Turk J Gastroenterol Off J Turk Soc Gastroenterol 31(2):99–104. https://​doi.​org/​10.​5152/​tjg.​2020.​181028CrossRef
35.
go back to reference Javad Hosseinzadeh-Attar M, Sharifi A, Nedjat S, Mohamadkhani A, Vahedi H (2020) The effect of vitamin D on serum asymmetric dimethylarginine in patients with mild to moderate ulcerative colitis. Int J Vitam Nutr Res Int Z fur Vitam und Ernahrungsforschung J Int de vitaminol et de nutr 90(1–2):17–22. https://doi.org/10.1024/0300-9831/a000303CrossRef Javad Hosseinzadeh-Attar M, Sharifi A, Nedjat S, Mohamadkhani A, Vahedi H (2020) The effect of vitamin D on serum asymmetric dimethylarginine in patients with mild to moderate ulcerative colitis. Int J Vitam Nutr Res Int Z fur Vitam und Ernahrungsforschung J Int de vitaminol et de nutr 90(1–2):17–22. https://​doi.​org/​10.​1024/​0300-9831/​a000303CrossRef
41.
go back to reference Reches L, Israeli E (2020) Disability among patients with inflammatory bowel diseases: a cross sectional study. Harefuah 159(11):815–819PubMed Reches L, Israeli E (2020) Disability among patients with inflammatory bowel diseases: a cross sectional study. Harefuah 159(11):815–819PubMed
42.
go back to reference Veselov AV, Belousova EA, Bakulin IG, Uspenskiy YP, Dreval RO, Shkurko TV, Kashnikov BN, Fominykh YA, Knyazev OV, Romanov RI, Skalinskaia MI, Shipitsyn VV (2020) Economic burden and current status of the drug supply management for immune inflammatory diseases (by example of ulcerative colitis and crohn’s disease). Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 28(Special Issue):1137–1145. https://doi.org/10.32687/0869-866X-2020-28-s2-1137-1145CrossRefPubMed Veselov AV, Belousova EA, Bakulin IG, Uspenskiy YP, Dreval RO, Shkurko TV, Kashnikov BN, Fominykh YA, Knyazev OV, Romanov RI, Skalinskaia MI, Shipitsyn VV (2020) Economic burden and current status of the drug supply management for immune inflammatory diseases (by example of ulcerative colitis and crohn’s disease). Problemy sotsial’noi gigieny, zdravookhraneniia i istorii meditsiny 28(Special Issue):1137–1145. https://​doi.​org/​10.​32687/​0869-866X-2020-28-s2-1137-1145CrossRefPubMed
45.
go back to reference Mascitelli L, Goldstein MR, Pezzetta F (2010) Vitamin D deficiency and cardiovascular diseases. Recent Prog Med 101(5):202–211 Mascitelli L, Goldstein MR, Pezzetta F (2010) Vitamin D deficiency and cardiovascular diseases. Recent Prog Med 101(5):202–211
48.
go back to reference Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, Hayee B, Lomer MCE, Parkes GC, Selinger C, Barrett KJ, Davies RJ, Bennett C, Gittens S, Dunlop MG, Faiz O, Fraser A, Garrick V, Johnston PD, Parkes M, Sanderson J, Terry H, Gaya DR, Iqbal TH, Taylor SA, Smith M, Brookes M, Hansen R, Hawthorne AB (2019) British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut 68(Suppl 3):s1–s106. https://doi.org/10.1136/gutjnl-2019-318484CrossRefPubMed Lamb CA, Kennedy NA, Raine T, Hendy PA, Smith PJ, Limdi JK, Hayee B, Lomer MCE, Parkes GC, Selinger C, Barrett KJ, Davies RJ, Bennett C, Gittens S, Dunlop MG, Faiz O, Fraser A, Garrick V, Johnston PD, Parkes M, Sanderson J, Terry H, Gaya DR, Iqbal TH, Taylor SA, Smith M, Brookes M, Hansen R, Hawthorne AB (2019) British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults. Gut 68(Suppl 3):s1–s106. https://​doi.​org/​10.​1136/​gutjnl-2019-318484CrossRefPubMed
53.
go back to reference Tabatabaeizadeh SA, Avan A, Bahrami A, Khodashenas E, Esmaeili H, Ferns GA, Abdizadeh MF, Ghayour-Mobarhan M (2017) High dose supplementation of vitamin D affects measures of systemic inflammation: reductions in high sensitivity C-reactive protein level and neutrophil to lymphocyte ratio (NLR) distribution. J Cell Biochem 118(12):4317–4322. https://doi.org/10.1002/jcb.26084CrossRefPubMed Tabatabaeizadeh SA, Avan A, Bahrami A, Khodashenas E, Esmaeili H, Ferns GA, Abdizadeh MF, Ghayour-Mobarhan M (2017) High dose supplementation of vitamin D affects measures of systemic inflammation: reductions in high sensitivity C-reactive protein level and neutrophil to lymphocyte ratio (NLR) distribution. J Cell Biochem 118(12):4317–4322. https://​doi.​org/​10.​1002/​jcb.​26084CrossRefPubMed
55.
64.
go back to reference Macdonald HM, Reid IR, Gamble GD, Fraser WD, Tang JC, Wood AD (2018) 25-Hydroxyvitamin D threshold for the effects of vitamin D supplements on bone density: secondary analysis of a randomized controlled trial. J Bone Min Res Off J Am Soc Bone Min Res 33(8):1464–1469. https://doi.org/10.1002/jbmr.3442CrossRef Macdonald HM, Reid IR, Gamble GD, Fraser WD, Tang JC, Wood AD (2018) 25-Hydroxyvitamin D threshold for the effects of vitamin D supplements on bone density: secondary analysis of a randomized controlled trial. J Bone Min Res Off J Am Soc Bone Min Res 33(8):1464–1469. https://​doi.​org/​10.​1002/​jbmr.​3442CrossRef
Metadata
Title
Effects of vitamin D supplementation on blood markers in ulcerative colitis patients: a systematic review and meta-analysis
Authors
Yuanyuan Guan
Yang Hao
Yun Guan
Huaien Bu
Hongwu Wang
Publication date
01-02-2022
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nutrition / Issue 1/2022
Print ISSN: 1436-6207
Electronic ISSN: 1436-6215
DOI
https://doi.org/10.1007/s00394-021-02603-2

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