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 17 October 2017

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News

Factors that predict relapse in Crohn's disease

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High vitamin D–binding protein concentration, low albumin, and mode of remission predict relapse in Crohn's disease, reports the most recent issue of Inflammatory Bowel Disease.

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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 levels, however, fluctuate less with season and sunlight. 

Dr Simon Ghaly and colleagues examined patients with CD in remission and determine any associations between vitamin D–binding protein, serum 25(OH)D, and the calculated free 25(OH)D concentrations with the risk of disease flare.

The team identified subjects 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. 

A disease flare occurred in 32%
Inflammatory Bowel Disease
The research team determined total and epimer-25(OH)D3, vitamin D–binding protein concentrations, and genotypes.

A total of 309 patients with CD met the inclusion criteria. 

The team observed that a disease flare occurred in 32%. 

The team noted that serum 25(OH)D3 was deficient in 12%, and insufficient 35% of patients. 

Total, free, and epimer-25(OH)D3 serum levels did not predict disease flare. 

The researchers found that higher vitamin D–binding protein concentrations significantly correlated with increased risk of disease flare. 

The team identified that vitamin D–binding protein concentration, low albumin, and medication-induced remission were significantly more associated with disease flare. 

Vitamin D–binding protein genotypes were significantly associated with 25(OH)D, and vitamin D–binding protein concentrations but not disease flare.

Dr Ghaly's team concludes, "Vitamin D deficiency was uncommon in our patients with CD in remission, and serum 25(OH)D3 did not predict disease flare, whereas higher vitamin D–binding protein concentrations were significantly associated with disease flare."

"Further investigations to explore the possible mechanisms for this association are warranted."

Inflamm Bowel Dis 2016: 22(10): 2456–2464
20 September 2016

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