Vitamin D Deficiency is Widely Prevalent in South Asian Patients with Inflammatory Bowel Disease
Notice bibliographique
Résumé
Purpose: There has been resurgent interest in recent years in the pro-hormone vitamin D beyond its classical role in bone metabolism to its role and plausible effects on immune regulation and inflammatory bowel disease (IBD). We postulated a wide prevalence of vitamin D deficiency in South Asian patients with implications for the control of their IBD. The aim of our study was to review vitamin D assessment in a South Asian IBD cohort. Methods: We conducted a retrospective review of 102 South Asian patients attending IBD clinics in our institution. Clinical data including demographics, disease characteristics (Montreal classification) and therapy were obtained from electronic record review. Serum 25-hydroxyvitamin D (25-OHD) concentrations were recorded in all patients tested and in all having serial measurements. Results: Of 102 patients reviewed 54 were male. The median age was 38 years (range 16-80), and mean disease duration was 9.4 years. Seventy-three patients had ulcerative colitis (UC) and 29 had Crohn's disease (CD). Five patients were current or ex smokers (4.9%). Vitamin D status was assessed in 51 patients (50%), 25 had serial measurements. Median 25-OHD was 8.85 (range 3.3-44.4). Fifty patients had levels <25 ng/ml consistent with deficiency and all 51 had insufficient levels <50 ng/ml. Of the patients with deficiency 34 had UC and 16 had CD. Of the UC patients, 17 had pancolitis, 13 had left sided disease and 4 proctitis. Of the CD patients 5 had penetrating disease and 4 had stricturing disease. Forty-two of the deficient patients had received steroids and 29 received immunomodulatory therapy (27 azathioprine, 3 methotrexate, 1 cyclosporin, 2 6MP, 10 infliximab, 6 adalimumab. Seven deficient patients (4 CD, 3 UC) required a colectomy and the mean 25-OHD level in this group was 10.7 (range 4.0-20.1 ng/ml). Mean time to surgery was 3.6 years (range 0-8 years). Of the CD patients 1 had a subtotal colectomy, 3 had hemicolectomy and of the UC patients 2 had subtotal colectomy and 1 had total colectomy. Conclusion: There was a high prevalence of Vitamin D deficiency in our patient cohort although assessment was suboptimal and probably reflective of a wider experience with disparate practices elsewhere. Patients with vitamin D deficiency appeared to have a more aggressive disease course with 14% of deficient patients requiring surgical management. The immunopathogenesis of vitamin D in IBD is a science in evolution underpinning exciting implications for gastroenterological research. Meanwhile vitamin D deficiency is under-recognised and consequently undertreated with likely implications for adequate disease control in this potentially vulnerable group.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».