Patients with inflammatory bowel diseases (IBD) have an increased risk of Clostridium difficile infection (CDI).
Cathelicidins are anti-microbial peptides that attenuate colitis and inhibit the effect of clostridial toxins.
Plasma calcifediol [25(OH)D] stimulates production of cathelicidins.
Dr Ananthakrishnan and colleagues from Massachussetts, USA examined the association between plasma 25(OH)D and CDI in patients with IBD.
From a multi-institutional IBD cohort, the research team identified patients with at least one measured plasma 25(OH)D.
|Each 1 ng/mL increase in plasma 25(OH)D was associated with a 4% reduction in risk of CDI|
|Alimentary Pharmacology & Therapeutics|
The team's primary outcome was development of CDI.
Multivariate logistic regression models adjusting for potential confounders were used to identify independent effect of plasma 25(OH)D on risk of CDI.
The team studied 3188 IBD patients of whom 35 patients developed CDI.
The research team observed that patients with CDI-IBD were older and had greater co-morbidity.
The mean plasma 25(OH)D level was significantly lower in patients who developed CDI compared to non-CDI-IBD patients.
On further analysis, the team observed that each 1 ng/mL increase in plasma 25(OH)D was associated with a 4% reduction in risk of CDI.
Compared to individuals with vitamin D >20 ng/mL, patients with levels <20 ng/mL were more likely to develop CDI.
The mean plasma 25(OH)D in patients with CDI who subsequently died was significantly lower compared to those who were alive at the end of follow-up.
Dr Ananthakrishnan's team concludes, "Higher plasma calcifediol [25(OH)D] is associated with reduced risk of C. difficile infection in patients with IBD."
"Further studies of therapeutic supplementation of vitamin D in patients with inflammatory bowel disease and C. difficile infection may be warranted."