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High Vitamin D-Binding Protein Concentration, Low Albumin, and Mode of Remission Predict Relapse in Crohn's Disease
Vitamin D (25(OH)D) deficiency occurs in active Crohn's disease (CD) and may be secondary to reduced sunlight exposure and oral intake. Vitamin D-binding protein (VDBP) levels, however, fluctuate less with season and sunlight. The aim, therefore, was to examine patients with CD in remission and...
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| Published in: | Inflammatory bowel diseases 2016-10, Vol.22 (10), p.2456-2464 |
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| container_end_page | 2464 |
| container_issue | 10 |
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| container_title | Inflammatory bowel diseases |
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| creator | Ghaly, Simon Murray, Kevin Baird, Angela Martin, Katherine Prosser, Ruth Mill, Justine Simms, Lisa A Hart, Prue H Radford-Smith, Graham Bampton, Peter A Lawrance, Ian C |
| description | Vitamin D (25(OH)D) deficiency occurs in active Crohn's disease (CD) and may be secondary to reduced sunlight exposure and oral intake. Vitamin D-binding protein (VDBP) levels, however, fluctuate less with season and sunlight. The aim, therefore, was to examine patients with CD in remission and determine any associations between VDBP, serum 25(OH)D, and the calculated free 25(OH)D concentrations with the risk of disease flare.
Subjects were identified from prospectively maintained inflammatory bowel disease databases at 3 teaching hospitals in Australia. Patients were in steroid-free clinical remission at the time of blood draw and were followed for at least 12 months. Total and epimer-25(OH)D3, VDBP concentrations, and genotypes were determined.
A total of 309 patients with CD (46% men) met the inclusion criteria. A disease flare occurred in 100 (32.4%). Serum 25(OH)D3 was deficient ( |
| doi_str_mv | 10.1097/MIB.0000000000000894 |
| format | article |
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Subjects were identified from prospectively maintained inflammatory bowel disease databases at 3 teaching hospitals in Australia. Patients were in steroid-free clinical remission at the time of blood draw and were followed for at least 12 months. Total and epimer-25(OH)D3, VDBP concentrations, and genotypes were determined.
A total of 309 patients with CD (46% men) met the inclusion criteria. A disease flare occurred in 100 (32.4%). Serum 25(OH)D3 was deficient (<50 nmol/L) in 36 (12%) and insufficient (50-75 nmol/L) in 107 (35%) patients. Total, free, and epimer-25(OH)D3 serum levels did not predict disease flare. Higher VDBP concentrations, however, significantly correlated with increased risk of disease flare (hazard ratio 1.2, 95% CI, 1.0-1.5). On multivariate analysis, VDBP concentration, low albumin, and medication-induced remission were significantly more associated with disease flare. VDBP genotypes were significantly associated with 25(OH)D and VDBP concentrations but not disease flare.
Vitamin D deficiency was uncommon in our patients with CD in remission, and serum 25(OH)D3 did not predict disease flare, whereas higher VDBP concentrations were significantly associated with disease flare. Further investigations to explore the possible mechanisms for this association are warranted.</description><identifier>ISSN: 1078-0998</identifier><identifier>EISSN: 1536-4844</identifier><identifier>DOI: 10.1097/MIB.0000000000000894</identifier><identifier>PMID: 27631600</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Aged ; Australia ; Crohn Disease - blood ; Crohn Disease - complications ; Crohn Disease - therapy ; Databases, Factual ; Disease Progression ; Humans ; Middle Aged ; Multivariate Analysis ; Proportional Hazards Models ; Prospective Studies ; Recurrence ; Remission Induction - methods ; Retrospective Studies ; Serum Albumin - analysis ; Vitamin D - analogs & derivatives ; Vitamin D - blood ; Vitamin D Deficiency - etiology ; Vitamin D-Binding Protein - blood</subject><ispartof>Inflammatory bowel diseases, 2016-10, Vol.22 (10), p.2456-2464</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c340t-ac09a81556d37a3bc7b459d1ace62b130f54d64dd4d0b908eb37fdc753e091833</citedby><cites>FETCH-LOGICAL-c340t-ac09a81556d37a3bc7b459d1ace62b130f54d64dd4d0b908eb37fdc753e091833</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27631600$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghaly, Simon</creatorcontrib><creatorcontrib>Murray, Kevin</creatorcontrib><creatorcontrib>Baird, Angela</creatorcontrib><creatorcontrib>Martin, Katherine</creatorcontrib><creatorcontrib>Prosser, Ruth</creatorcontrib><creatorcontrib>Mill, Justine</creatorcontrib><creatorcontrib>Simms, Lisa A</creatorcontrib><creatorcontrib>Hart, Prue H</creatorcontrib><creatorcontrib>Radford-Smith, Graham</creatorcontrib><creatorcontrib>Bampton, Peter A</creatorcontrib><creatorcontrib>Lawrance, Ian C</creatorcontrib><title>High Vitamin D-Binding Protein Concentration, Low Albumin, and Mode of Remission Predict Relapse in Crohn's Disease</title><title>Inflammatory bowel diseases</title><addtitle>Inflamm Bowel Dis</addtitle><description>Vitamin D (25(OH)D) deficiency occurs in active Crohn's disease (CD) and may be secondary to reduced sunlight exposure and oral intake. Vitamin D-binding protein (VDBP) levels, however, fluctuate less with season and sunlight. The aim, therefore, was to examine patients with CD in remission and determine any associations between VDBP, serum 25(OH)D, and the calculated free 25(OH)D concentrations with the risk of disease flare.
Subjects were identified from prospectively maintained inflammatory bowel disease databases at 3 teaching hospitals in Australia. Patients were in steroid-free clinical remission at the time of blood draw and were followed for at least 12 months. Total and epimer-25(OH)D3, VDBP concentrations, and genotypes were determined.
A total of 309 patients with CD (46% men) met the inclusion criteria. A disease flare occurred in 100 (32.4%). Serum 25(OH)D3 was deficient (<50 nmol/L) in 36 (12%) and insufficient (50-75 nmol/L) in 107 (35%) patients. Total, free, and epimer-25(OH)D3 serum levels did not predict disease flare. Higher VDBP concentrations, however, significantly correlated with increased risk of disease flare (hazard ratio 1.2, 95% CI, 1.0-1.5). On multivariate analysis, VDBP concentration, low albumin, and medication-induced remission were significantly more associated with disease flare. VDBP genotypes were significantly associated with 25(OH)D and VDBP concentrations but not disease flare.
Vitamin D deficiency was uncommon in our patients with CD in remission, and serum 25(OH)D3 did not predict disease flare, whereas higher VDBP concentrations were significantly associated with disease flare. Further investigations to explore the possible mechanisms for this association are warranted.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Australia</subject><subject>Crohn Disease - blood</subject><subject>Crohn Disease - complications</subject><subject>Crohn Disease - therapy</subject><subject>Databases, Factual</subject><subject>Disease Progression</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Recurrence</subject><subject>Remission Induction - methods</subject><subject>Retrospective Studies</subject><subject>Serum Albumin - analysis</subject><subject>Vitamin D - analogs & derivatives</subject><subject>Vitamin D - blood</subject><subject>Vitamin D Deficiency - etiology</subject><subject>Vitamin D-Binding Protein - blood</subject><issn>1078-0998</issn><issn>1536-4844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNqNkU1LxDAQhoMofqz-A5Hc9GB10qRtcnTXT1hRRL2WNJlqpJusTRfx3xtxFfHkzGGG4XlnBl5CdhkcMVDV8fXV-Ah-h1RihWyygpeZkEKsph4qmYFScoNsxfgCkKdU62Qjr0rOSoBNEi_d0zN9dIOeOU9Ps7Hz1vknetuHAdNkErxBP_R6cMEf0ml4oydds0jwIdXe0utgkYaW3uHMxZiYpETrzJAmnZ5HpJ9L-vDs9yM9dRF1xG2y1uou4s6yjsjD-dn95DKb3lxcTU6mmeEChkwbUFqyoigtrzRvTNWIQlmmDZZ5wzi0hbClsFZYaBRIbHjVWlMVHEExyfmIHHztnffhdYFxqNOPBrtOewyLWDNZSs6YVPk_0BwKVRYKEiq-UNOHGHts63nvZrp_rxnUn87UyZn6rzNJtre8sGhmaH9E31bwD1NEh-g</recordid><startdate>20161001</startdate><enddate>20161001</enddate><creator>Ghaly, Simon</creator><creator>Murray, Kevin</creator><creator>Baird, Angela</creator><creator>Martin, Katherine</creator><creator>Prosser, Ruth</creator><creator>Mill, Justine</creator><creator>Simms, Lisa A</creator><creator>Hart, Prue H</creator><creator>Radford-Smith, Graham</creator><creator>Bampton, Peter A</creator><creator>Lawrance, Ian C</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7T5</scope><scope>H94</scope></search><sort><creationdate>20161001</creationdate><title>High Vitamin D-Binding Protein Concentration, Low Albumin, and Mode of Remission Predict Relapse in Crohn's Disease</title><author>Ghaly, Simon ; Murray, Kevin ; Baird, Angela ; Martin, Katherine ; Prosser, Ruth ; Mill, Justine ; Simms, Lisa A ; Hart, Prue H ; Radford-Smith, Graham ; Bampton, Peter A ; Lawrance, Ian C</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c340t-ac09a81556d37a3bc7b459d1ace62b130f54d64dd4d0b908eb37fdc753e091833</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Australia</topic><topic>Crohn Disease - blood</topic><topic>Crohn Disease - complications</topic><topic>Crohn Disease - therapy</topic><topic>Databases, Factual</topic><topic>Disease Progression</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Recurrence</topic><topic>Remission Induction - methods</topic><topic>Retrospective Studies</topic><topic>Serum Albumin - analysis</topic><topic>Vitamin D - analogs & derivatives</topic><topic>Vitamin D - blood</topic><topic>Vitamin D Deficiency - etiology</topic><topic>Vitamin D-Binding Protein - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghaly, Simon</creatorcontrib><creatorcontrib>Murray, Kevin</creatorcontrib><creatorcontrib>Baird, Angela</creatorcontrib><creatorcontrib>Martin, Katherine</creatorcontrib><creatorcontrib>Prosser, Ruth</creatorcontrib><creatorcontrib>Mill, Justine</creatorcontrib><creatorcontrib>Simms, Lisa A</creatorcontrib><creatorcontrib>Hart, Prue H</creatorcontrib><creatorcontrib>Radford-Smith, Graham</creatorcontrib><creatorcontrib>Bampton, Peter A</creatorcontrib><creatorcontrib>Lawrance, Ian C</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Inflammatory bowel diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghaly, Simon</au><au>Murray, Kevin</au><au>Baird, Angela</au><au>Martin, Katherine</au><au>Prosser, Ruth</au><au>Mill, Justine</au><au>Simms, Lisa A</au><au>Hart, Prue H</au><au>Radford-Smith, Graham</au><au>Bampton, Peter A</au><au>Lawrance, Ian C</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Vitamin D-Binding Protein Concentration, Low Albumin, and Mode of Remission Predict Relapse in Crohn's Disease</atitle><jtitle>Inflammatory bowel diseases</jtitle><addtitle>Inflamm Bowel Dis</addtitle><date>2016-10-01</date><risdate>2016</risdate><volume>22</volume><issue>10</issue><spage>2456</spage><epage>2464</epage><pages>2456-2464</pages><issn>1078-0998</issn><eissn>1536-4844</eissn><abstract>Vitamin D (25(OH)D) deficiency occurs in active Crohn's disease (CD) and may be secondary to reduced sunlight exposure and oral intake. Vitamin D-binding protein (VDBP) levels, however, fluctuate less with season and sunlight. The aim, therefore, was to examine patients with CD in remission and determine any associations between VDBP, serum 25(OH)D, and the calculated free 25(OH)D concentrations with the risk of disease flare.
Subjects were identified from prospectively maintained inflammatory bowel disease databases at 3 teaching hospitals in Australia. Patients were in steroid-free clinical remission at the time of blood draw and were followed for at least 12 months. Total and epimer-25(OH)D3, VDBP concentrations, and genotypes were determined.
A total of 309 patients with CD (46% men) met the inclusion criteria. A disease flare occurred in 100 (32.4%). Serum 25(OH)D3 was deficient (<50 nmol/L) in 36 (12%) and insufficient (50-75 nmol/L) in 107 (35%) patients. Total, free, and epimer-25(OH)D3 serum levels did not predict disease flare. Higher VDBP concentrations, however, significantly correlated with increased risk of disease flare (hazard ratio 1.2, 95% CI, 1.0-1.5). On multivariate analysis, VDBP concentration, low albumin, and medication-induced remission were significantly more associated with disease flare. VDBP genotypes were significantly associated with 25(OH)D and VDBP concentrations but not disease flare.
Vitamin D deficiency was uncommon in our patients with CD in remission, and serum 25(OH)D3 did not predict disease flare, whereas higher VDBP concentrations were significantly associated with disease flare. Further investigations to explore the possible mechanisms for this association are warranted.</abstract><cop>United States</cop><pmid>27631600</pmid><doi>10.1097/MIB.0000000000000894</doi><tpages>9</tpages></addata></record> |
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| ispartof | Inflammatory bowel diseases, 2016-10, Vol.22 (10), p.2456-2464 |
| issn | 1078-0998 1536-4844 |
| language | eng |
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| source | Oxford Journals Online |
| subjects | Adolescent Adult Aged Australia Crohn Disease - blood Crohn Disease - complications Crohn Disease - therapy Databases, Factual Disease Progression Humans Middle Aged Multivariate Analysis Proportional Hazards Models Prospective Studies Recurrence Remission Induction - methods Retrospective Studies Serum Albumin - analysis Vitamin D - analogs & derivatives Vitamin D - blood Vitamin D Deficiency - etiology Vitamin D-Binding Protein - blood |
| title | High Vitamin D-Binding Protein Concentration, Low Albumin, and Mode of Remission Predict Relapse in Crohn's Disease |
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