Free and bioavailable 25-hydroxyvitamin D concentrations are associated with disease activity in pediatric patients with newly diagnosed treatment naive ulcerative colitis

Cary G. Sauer, Matthew S. Loop, Suresh Venkateswaran, Vin Tangpricha, Thomas R. Ziegler, Ashish Dhawan, Courtney McCall, Erin Bonkowski, David R. Mack, Brendan Boyle, Anne M. Griffiths, Neal S. Leleiko, David J. Keljo, James Markowitz, Susan S. Baker, Joel Rosh, Robert N. Baldassano, Sonia Davis, Shiven Patel, Jessie WangAlison Marquis, Krista L. Spada, Subra Kugathasan, Thomas Walters, Jeffrey S. Hyams, Lee A. Denson

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Vitamin D regulates intestinal epithelial and immune functions, and vitamin D receptor deficiency increases the severity of murine colitis. Bioavailable 25-hydroxyvitamin D (25(OH)D) is available to target tissues and may be a driver of immune function. The aim is to evaluate the relationship of bioavailable 25(OH)D to the clinical expression of treatment naive pediatric ulcerative colitis (UC). Methods The PROTECT (Predicting Response to Standardized Pediatric Colitis Therapy) study enrolled children ≤17 years newly diagnosed with UC. Free and total 25(OH)D were directly measured and 25(OH)D fractions were compared with disease activity measures. Results Data were available on 388 subjects, mean age 12.7 years, 49% female, 84% with extensive/pancolitis. The median (IQR) total 25(OH)D concentration was 28.5 (23.9, 34.8) ng/mL, and 57% of subjects demonstrated insufficient vitamin D status (25(OH)D < 30 ng/mL). We found no evidence of association between total 25(OH)D and disease activity. Regression models adjusted for age, sex, race, and ethnicity demonstrated that an increase from 25 th to 75 th percentile for bioavailable and free 25(OH)D were associated with a mean (95 th CI) decrease in the Pediatric Ulcerative Colitis Activity Index (PUCAI) of -8.7 (-13.7, -3.6) and -3.1 (-5.0, -1.2), respectively. No associations were detected between 25(OH)D fractions and fecal calprotectin or Mayo endoscopy score. Conclusions Vitamin D insufficiency is highly prevalent in children with newly diagnosed UC. We found associations of free and bioavailable, but not total 25(OH)D, with PUCAI. Bioavailable vitamin D may contribute to UC pathophysiology and clinical activity.

Original languageEnglish (US)
Pages (from-to)641-650
Number of pages10
JournalInflammatory bowel diseases
Volume24
Issue number3
DOIs
StatePublished - Feb 16 2018
Externally publishedYes

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Ulcerative Colitis
Vitamin D
Pediatrics
Colitis
Leukocyte L1 Antigen Complex
Free Association
Calcitriol Receptors
Vitamin D Deficiency
Therapeutics
Endoscopy
25-hydroxyvitamin D
Pediatric ulcerative colitis

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Gastroenterology

Cite this

Sauer, Cary G. ; Loop, Matthew S. ; Venkateswaran, Suresh ; Tangpricha, Vin ; Ziegler, Thomas R. ; Dhawan, Ashish ; McCall, Courtney ; Bonkowski, Erin ; Mack, David R. ; Boyle, Brendan ; Griffiths, Anne M. ; Leleiko, Neal S. ; Keljo, David J. ; Markowitz, James ; Baker, Susan S. ; Rosh, Joel ; Baldassano, Robert N. ; Davis, Sonia ; Patel, Shiven ; Wang, Jessie ; Marquis, Alison ; Spada, Krista L. ; Kugathasan, Subra ; Walters, Thomas ; Hyams, Jeffrey S. ; Denson, Lee A. / Free and bioavailable 25-hydroxyvitamin D concentrations are associated with disease activity in pediatric patients with newly diagnosed treatment naive ulcerative colitis. In: Inflammatory bowel diseases. 2018 ; Vol. 24, No. 3. pp. 641-650.
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title = "Free and bioavailable 25-hydroxyvitamin D concentrations are associated with disease activity in pediatric patients with newly diagnosed treatment naive ulcerative colitis",
abstract = "Background Vitamin D regulates intestinal epithelial and immune functions, and vitamin D receptor deficiency increases the severity of murine colitis. Bioavailable 25-hydroxyvitamin D (25(OH)D) is available to target tissues and may be a driver of immune function. The aim is to evaluate the relationship of bioavailable 25(OH)D to the clinical expression of treatment naive pediatric ulcerative colitis (UC). Methods The PROTECT (Predicting Response to Standardized Pediatric Colitis Therapy) study enrolled children ≤17 years newly diagnosed with UC. Free and total 25(OH)D were directly measured and 25(OH)D fractions were compared with disease activity measures. Results Data were available on 388 subjects, mean age 12.7 years, 49{\%} female, 84{\%} with extensive/pancolitis. The median (IQR) total 25(OH)D concentration was 28.5 (23.9, 34.8) ng/mL, and 57{\%} of subjects demonstrated insufficient vitamin D status (25(OH)D < 30 ng/mL). We found no evidence of association between total 25(OH)D and disease activity. Regression models adjusted for age, sex, race, and ethnicity demonstrated that an increase from 25 th to 75 th percentile for bioavailable and free 25(OH)D were associated with a mean (95 th CI) decrease in the Pediatric Ulcerative Colitis Activity Index (PUCAI) of -8.7 (-13.7, -3.6) and -3.1 (-5.0, -1.2), respectively. No associations were detected between 25(OH)D fractions and fecal calprotectin or Mayo endoscopy score. Conclusions Vitamin D insufficiency is highly prevalent in children with newly diagnosed UC. We found associations of free and bioavailable, but not total 25(OH)D, with PUCAI. Bioavailable vitamin D may contribute to UC pathophysiology and clinical activity.",
author = "Sauer, {Cary G.} and Loop, {Matthew S.} and Suresh Venkateswaran and Vin Tangpricha and Ziegler, {Thomas R.} and Ashish Dhawan and Courtney McCall and Erin Bonkowski and Mack, {David R.} and Brendan Boyle and Griffiths, {Anne M.} and Leleiko, {Neal S.} and Keljo, {David J.} and James Markowitz and Baker, {Susan S.} and Joel Rosh and Baldassano, {Robert N.} and Sonia Davis and Shiven Patel and Jessie Wang and Alison Marquis and Spada, {Krista L.} and Subra Kugathasan and Thomas Walters and Hyams, {Jeffrey S.} and Denson, {Lee A.}",
year = "2018",
month = "2",
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language = "English (US)",
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Sauer, CG, Loop, MS, Venkateswaran, S, Tangpricha, V, Ziegler, TR, Dhawan, A, McCall, C, Bonkowski, E, Mack, DR, Boyle, B, Griffiths, AM, Leleiko, NS, Keljo, DJ, Markowitz, J, Baker, SS, Rosh, J, Baldassano, RN, Davis, S, Patel, S, Wang, J, Marquis, A, Spada, KL, Kugathasan, S, Walters, T, Hyams, JS & Denson, LA 2018, 'Free and bioavailable 25-hydroxyvitamin D concentrations are associated with disease activity in pediatric patients with newly diagnosed treatment naive ulcerative colitis', Inflammatory bowel diseases, vol. 24, no. 3, pp. 641-650. https://doi.org/10.1093/ibd/izx052

Free and bioavailable 25-hydroxyvitamin D concentrations are associated with disease activity in pediatric patients with newly diagnosed treatment naive ulcerative colitis. / Sauer, Cary G.; Loop, Matthew S.; Venkateswaran, Suresh; Tangpricha, Vin; Ziegler, Thomas R.; Dhawan, Ashish; McCall, Courtney; Bonkowski, Erin; Mack, David R.; Boyle, Brendan; Griffiths, Anne M.; Leleiko, Neal S.; Keljo, David J.; Markowitz, James; Baker, Susan S.; Rosh, Joel; Baldassano, Robert N.; Davis, Sonia; Patel, Shiven; Wang, Jessie; Marquis, Alison; Spada, Krista L.; Kugathasan, Subra; Walters, Thomas; Hyams, Jeffrey S.; Denson, Lee A.

In: Inflammatory bowel diseases, Vol. 24, No. 3, 16.02.2018, p. 641-650.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Free and bioavailable 25-hydroxyvitamin D concentrations are associated with disease activity in pediatric patients with newly diagnosed treatment naive ulcerative colitis

AU - Sauer, Cary G.

AU - Loop, Matthew S.

AU - Venkateswaran, Suresh

AU - Tangpricha, Vin

AU - Ziegler, Thomas R.

AU - Dhawan, Ashish

AU - McCall, Courtney

AU - Bonkowski, Erin

AU - Mack, David R.

AU - Boyle, Brendan

AU - Griffiths, Anne M.

AU - Leleiko, Neal S.

AU - Keljo, David J.

AU - Markowitz, James

AU - Baker, Susan S.

AU - Rosh, Joel

AU - Baldassano, Robert N.

AU - Davis, Sonia

AU - Patel, Shiven

AU - Wang, Jessie

AU - Marquis, Alison

AU - Spada, Krista L.

AU - Kugathasan, Subra

AU - Walters, Thomas

AU - Hyams, Jeffrey S.

AU - Denson, Lee A.

PY - 2018/2/16

Y1 - 2018/2/16

N2 - Background Vitamin D regulates intestinal epithelial and immune functions, and vitamin D receptor deficiency increases the severity of murine colitis. Bioavailable 25-hydroxyvitamin D (25(OH)D) is available to target tissues and may be a driver of immune function. The aim is to evaluate the relationship of bioavailable 25(OH)D to the clinical expression of treatment naive pediatric ulcerative colitis (UC). Methods The PROTECT (Predicting Response to Standardized Pediatric Colitis Therapy) study enrolled children ≤17 years newly diagnosed with UC. Free and total 25(OH)D were directly measured and 25(OH)D fractions were compared with disease activity measures. Results Data were available on 388 subjects, mean age 12.7 years, 49% female, 84% with extensive/pancolitis. The median (IQR) total 25(OH)D concentration was 28.5 (23.9, 34.8) ng/mL, and 57% of subjects demonstrated insufficient vitamin D status (25(OH)D < 30 ng/mL). We found no evidence of association between total 25(OH)D and disease activity. Regression models adjusted for age, sex, race, and ethnicity demonstrated that an increase from 25 th to 75 th percentile for bioavailable and free 25(OH)D were associated with a mean (95 th CI) decrease in the Pediatric Ulcerative Colitis Activity Index (PUCAI) of -8.7 (-13.7, -3.6) and -3.1 (-5.0, -1.2), respectively. No associations were detected between 25(OH)D fractions and fecal calprotectin or Mayo endoscopy score. Conclusions Vitamin D insufficiency is highly prevalent in children with newly diagnosed UC. We found associations of free and bioavailable, but not total 25(OH)D, with PUCAI. Bioavailable vitamin D may contribute to UC pathophysiology and clinical activity.

AB - Background Vitamin D regulates intestinal epithelial and immune functions, and vitamin D receptor deficiency increases the severity of murine colitis. Bioavailable 25-hydroxyvitamin D (25(OH)D) is available to target tissues and may be a driver of immune function. The aim is to evaluate the relationship of bioavailable 25(OH)D to the clinical expression of treatment naive pediatric ulcerative colitis (UC). Methods The PROTECT (Predicting Response to Standardized Pediatric Colitis Therapy) study enrolled children ≤17 years newly diagnosed with UC. Free and total 25(OH)D were directly measured and 25(OH)D fractions were compared with disease activity measures. Results Data were available on 388 subjects, mean age 12.7 years, 49% female, 84% with extensive/pancolitis. The median (IQR) total 25(OH)D concentration was 28.5 (23.9, 34.8) ng/mL, and 57% of subjects demonstrated insufficient vitamin D status (25(OH)D < 30 ng/mL). We found no evidence of association between total 25(OH)D and disease activity. Regression models adjusted for age, sex, race, and ethnicity demonstrated that an increase from 25 th to 75 th percentile for bioavailable and free 25(OH)D were associated with a mean (95 th CI) decrease in the Pediatric Ulcerative Colitis Activity Index (PUCAI) of -8.7 (-13.7, -3.6) and -3.1 (-5.0, -1.2), respectively. No associations were detected between 25(OH)D fractions and fecal calprotectin or Mayo endoscopy score. Conclusions Vitamin D insufficiency is highly prevalent in children with newly diagnosed UC. We found associations of free and bioavailable, but not total 25(OH)D, with PUCAI. Bioavailable vitamin D may contribute to UC pathophysiology and clinical activity.

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U2 - 10.1093/ibd/izx052

DO - 10.1093/ibd/izx052

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JO - Inflammatory Bowel Diseases

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