Vitamin D deficiency common in patients with IBD, chronic liver disease

October 06, 2008

New research presented at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando found patients with inflammatory bowel disease or chronic liver disease were at increased risk of developing Vitamin D deficiencies. Two separate studies highlight the importance of regular Vitamin D checkups in the evaluation of patients with certain digestive diseases.

For IBD Patients, Vitamin D Deficiency Associated with Lower Quality of Life and Higher Disease Activity

Researchers at the Medical College of Wisconsin investigated whether Vitamin D deficiency in patients with IBD is associated with a lower quality of life or higher disease activity independent of other known risk factors and medication use.

Disease activity and quality of life were assessed using validated questionnaires, which were administered at every clinic visit. The researchers also looked at the prevalence and seasonality of Vitamin D deficiency in this inflammatory bowel disease population, as well as its association with IBD-related hospitalizations, surgeries and medication use.

This retrospective cohort study conducted by Dr. Alex Ulitsky and his colleagues analyzed vitamin D levels of 504 inflammatory bowel disease patients. They recorded the patients' lowest Vitamin D measurements and date when each low measurement was taken.

Dr. Ulitsky and his team found almost 50 percent of the patients were Vitamin D deficient at some point, with 11 percent being severely deficient. Vitamin D deficiency was not significantly associated with being hospitalized for IBD or having IBD-related surgeries. However, in both Crohn's disease (CD) and ulcerative colitis (UC) patients, vitamin D deficiency was independently associated with having increased disease activity scores compared to those with normal levels of Vitamin D. Vitamin D deficient CD patients, but not UC patients, had worse quality of life when compared to patients who were not Vitamin D deficient.

According to Dr. Ulitsky, "All IBD patients, irrespective of their disease, disease location or nature should have their Vitamin D levels checked regularly and corrected aggressively when insufficiency is found."

Vitamin D Deficiency Prevalent in Patients with Chronic Liver Disease

Researchers from the University of Tennessee in Memphis measured the vitamin D levels of 118 chronic liver disease patients. Researchers found 92.4 percent of chronic liver patients had some degree of vitamin D deficiency and at least one third were severely deficient. Severe vitamin D deficiency was more common among cirrhotics.

"Since deficiency is common among these patients, Vitamin D replacement may hopefully prevent osteoporosis and other bone complications related to end stage liver disease," said lead researcher Dr. Satheesh P. Nair.

The study included 43 hepatitis C patients with cirrhosis; 57 hepatitis C patients without cirrhosis; 18 cirrhosis patients without hepatitis C. The severity of vitamin D deficiency was divided into three groups: mild (between 20-32 ng/ml), moderate (between 7-20 ng/ml), and severe (less than 7 ng/ml).

Importance of Vitamin D and Bone Health

Vitamin D, a fat-soluble vitamin, helps the body absorb calcium and plays a crucial role in the growth and maintenance of strong, healthy bones. A lack of vitamin D causes calcium-depleted bone, which can weaken the bones and increase the risk of fractures resulting from osteoporosis.

A diet rich in vitamin D, such as fish, eggs, fortified milk, and cod liver oil, is essential to maintaining good bone health.

American College of Gastroenterology

---

---

	The Comfort of Home for Chronic Liver Disease: A Guide for Caregivers by Lucy Mathew NP (Author), Jill Chang (Author), Maria M. Meyer (Author), RN Paula Derr (Author) Despite the growing number of hepatitis B and C and liver cancer patients in the United States, knowledge of liver disease is limited even among health care professionals. A caregiver that knows more about this complex affliction can greatly increase a patient's ability to cope. This disease-specific guide aims to educate and instruct both professional home-health aides and family caregivers, in order to ensure the patient's quality of life and comfort and help caregivers through challenging courses of treatment.
	Prevention of Progression in Chronic Liver Disease by N. Hiyashi (Editor), M.P. Manns (Editor) In several liver diseases, the underlying cause cannot always be eliminated, i.e. the progression of liver disease cannot be prevented. This is particularly true for non-responders to the treatment of chronic hepatitis C (HCV). It is relevant for more than 40% of patients with HCV genotype 1 and up to 20% of patients with genotype 2 or 3. Several approaches are now underway to prevent or ameliorate mechanisms of disease progression. In Asia, and particularly in Japan, Glycyrrhizine-SNMC has been widely used for this purpose. At present, SNMC is under clinical evaluation in Europe.
	Surrogate Markers to Assess Efficacy of Treatment in Chronic Liver Diseases (Falk Symposium) by J. Reichen (Editor), Raoul E. Poupon (Editor) Recent years have seen an increasing number of supposedly active drugs for the treatment of chronic liver diseases, e.g. ursodeoxycholate for treatment of cholestatic conditions and alpha-interferon for the treatment of chronic viral hepatitis. However, in all controlled studies, hard end-points such as survival or need for transplantation often cannot be obtained, owing to the prolonged course of chronic liver diseases up to the time of hepatic decompensation and death. Therefore, surrogate markers for the different conditions are sorely needed in order to assess the value of these novel treatment modalities. This book, the proceedings of an International Falk Workshop held in Basel, Switzerland, October 23-24, 1995, aims to define surrogate markers and to evaluate...
	Complications of Chronic Liver Disease by William G. Rector (Author) Organized around specific clinical problems, this book contains a current review of the treatment of complications of cirrhosis. It also features chapters on gastro-intestinal complications of cirrhosis, and methods of evaluation of the severity and prognosis of chronic liver disease. The book is aimed at gastroenterologists, hepatologists, primary care physicians and general surgeons.
	Metabolic Aspects of Chronic Liver Disease by Ami Schattner (Editor) This book discusses in detail new aspects of the metabolic basis of important chronic liver diseases. Entities such as non-alcoholic fatty liver disease (fatty liver and Non-Alcoholic SteatoHepatitis - NASH), diabetes in chronic hepatitis C, hemochromatosis, Wilson's disease, Gaucher disease, porphyria, as well as liver cirrhosis and its metabolic consequences will be discussed in detail. These clinical conditions are highly prevalent and affect millions of patients in the USA and world-wide. For example, non-alcoholic fatty liver disease is the most common cause of elevated liver enzymes in the general population. This field has been practically transformed over the last few years, with many new insights gained, regarding both pathogenesis and effective novel treatments.
	Female Hepatology: Favorable Role of Female Factors in Chronic Liver Disease (Hepatology Research and Clnical Developments Series) by Ichiro Shimizu (Author) Sex does matter. One of the most compelling reasons for understanding the biological differences, which are not so explained at this time, is that there are striking differences in human disease. The most obvious and best-studied differences between the sexes are in the reproductive systems. Much less study has been done on sex differences in non-reproductive areas of biology. Liver cancer is undoubtedly predominant in men and post menopausal women. Almost anyone may 'feel', but not recognize the sex-associated difference in liver cancer as a fact. How does sex matter in the incidence of liver cancer? After considering the data and examples presented in this book, anyone will be provided unique opportunities to obtain a better understanding of differences of chronic liver disease between...
	Chronic Diseases of the Liver, Blood, and Lungs: Their True Nature, Rational Treatment and Positive Cure by Ray Vaughn Pierce (Author)
	Dr. Melissa Palmer's Guide To Hepatitis and Liver Disease by Melissa Palmer (Author) In the United States alone, more than four million people are infected with the hepatitis C virus, and chronic liver disease is the twelfth leading cause of death. In this revised and updated edition of her groundbreaking 2000 book, renowned hepatologist Dr. Melissa Palmer discusses all facets of liver disease, from symptoms and tests to treatment options and lifestyle changes. In addition, this comprehensive handbook reveals cutting-edge research on the dangers of hepatitis C, one of the world's fasting-growing microbial threats.
	Acing The GI Board Exam: The Ultimate Crunch-Time Resource by Brennan Spiegel MD MSHS (Author) In today’s fast-paced world, gastroenterology & hepatology residents and fellows struggle to find the time to study for the board exams, prepare for teaching rounds, or just plain read. What is the best way to effectively prepare and study if reading multiple resources can’t seem to fit into your daily schedule? The answer to your study questions (and study time!) can be found inside: Acing the GI Board Exam: The Ultimate Crunch-Time Resource Traditional textbooks usually feature long and detailed discussions that are not directly relevant to board and re-certification exams. On the flip side, many board review manuals provide lists and bullet points lacking sufficient background and context. Acing the GI Board Exam by Dr. Brennan Spiegel aims to fill the unmet...
	ACSM's Exercise Management for Persons with Chronic Diseases and Disabilities-3rd Edition by American College of Sports Medicine (Author), J. Larry Durstine (Author), Geoffrey Moore (Author), Patricia Painter (Author), Scott Roberts (Author) Now in its third edition, ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities offers both exercise and health professionals the latest research and applications for integrating exercise into the treatment of 49 chronic diseases and disabilities. This reference was developed by the American College of Sports Medicine (ACSM) and written by contributors with significant clinical and research experience in exercise programming for people with chronic conditions. ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities, Third Edition, contains tools to assist in the coordination of exercise within an integrated model of patient care. The updated edition presents a framework for determining functional capacity in persons with chronic diseases...