Irritable Bowel Disease Subjects Have Significantly Lower Intakes of Vitamin D and Vitamin K Compared to Controls

by | May 16, 2023 | 2023, Digestive Health, Irritable Bowel Syndrome, Vitamin D - Recommended Levels, Vitamin K

Written by Taylor Woosley, Staff Writer. Results show statistically significant differences in mean vitamin K intake (p < 0.001) and mean vitamin D intake (p = 0.03) between healthy controls and subjects with irritable bowel disease. 

digestive healthInflammatory bowel disease (IBD) is a chronic complex inflammatory gut pathological condition which is associated with significant morbidity1. IBD can be subdivided into two sub-categories of disorders, Crohn’s disease (CD), and ulcerative colitis (UC), each with dissimilar presentations and pathologies2. It is believed to arise from a shared interaction between genetic and environmental influences, resulting in an imbalance between pro-inflammatory and anti-inflammatory signaling3.

Due to gut microbiome dysbiosis, subjects with IBD may have increased intestinal permeability, dysmotility, chronic inflammation, autoimmunity, and even altered central neuronal activity4. Several observational studies have reported that IBD subjects had a higher prevalence of vitamin D deficiency, which has been studied for its anti-inflammatory effects5. Furthermore, research has shown that IBD and other metabolic diseases can lead to a long-term reduction in vitamin K-producing microbiota, resulting in vitamin K deficiency, which impairs overall metabolic balance6.

Vernia et al. conducted a study to assess the dietary intake of vitamin K in IBD, seeking correlations with demographics and disease characteristics. Subjects were 193 patients with diagnosed IBD, consisting of 100 (51.81%) male and 93 (49.19%) female, who visited a IBD referral center between January 2016 and January 2020. The mean age was 50.69 ± 16.71 years. 89 (46.11%) had CD and 104 (53.89%) had UC. Disease activity was assessed using the Harvey-Bradshaw index in CD and the Partial Mayo score in UC. Additionally, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were measured.

Food intake was determined by subjects completing a food frequency checklist, which was adapted from a 22-item quantitative food frequency questionnaire. Dietary intake from IBD participants were compared with those of healthy family members accompanying the non-gastroenterological outpatients of the department and staff members (199 controls). Data recorded from IBD participants and controls were expressed as a percent of the recommended daily allowance (RDA) for vitamin D, using the reference values of 15-20 µg/d. RDA values of vitamin K were 140 µg/d for females and males up to 59 years old, and 170 µg/d for subjects >60 years.

Data was compared using the t-test for normally distributed parameters, the Mann-Whitney test was utilized for skewed data, and the chi-square test was used for proportional data. Significant findings of the study are as follows:

  • Mean vitamin K intake was 117.86 ±72 SD µg/day in the IBD group (78.72% RDA) and 203.12 ± 166.93 SD µg/day in the control group (138.79% RDA). The difference between the healthy controls and IBD participants were statistically significant (p < 0.001).
  • Mean vitamin D intake was 8.23 ±57 SD µg/day in the IBD group (53.76% RDA) and 9.67 ± 5.91 µg/day (63.58% RDA) in the controls (p = 0.03). In the IBD group, the total daily vitamin K intake was non-significantly lower in CD (110.64 ± 120.11 µg/day, 75.55% RDA) than in UC (124.04 ± 132.38 SD µg/day, 81.43% RDA).
  • Vitamin K intake was unaffected based on disease state (active or in remission), despite non-significantly lower values in the active disease group (108.93 ±37 µg/day vs. 122.58 ± 135.15 µg/day, in remission; p = 0.50).
  • Conversely, vitamin D intake was significantly reduced in patients with active disease (7.17 ±05 µg/day versus 8.72 ± 4.7 µg/day, in remission; p = 0.01).

Results of the study show that subjects with irritable bowel disease have a significantly lower intake of vitamin D and vitamin K compared to healthy controls. Further research should continue to explore the effects of active disease states on vitamin D and vitamin K levels in subjects with IBD.

Source: Vernia, Filippo, Giorgia Burrelli Scotti, Noemi Sara Bertetti, Giuseppe Donato, Stefano Necozione, Piero Vernia, and Nadia Pallotta. “Low Vitamin K and Vitamin D Dietary Intake in Patients with Inflammatory Bowel Diseases.” Nutrients 15, no. 7 (2023): 1678.

© © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons
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Posted May 16, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Khan I, Ullah N, Zha L, et al. Alteration of Gut Microbiota in Inflammatory Bowel Disease (IBD): Cause or Consequence? IBD Treatment Targeting the Gut Microbiome. Pathogens. Aug 13 2019;8(3)doi:10.3390/pathogens8030126
  2. Dowdell AS, Colgan SP. Metabolic Host-Microbiota Interactions in Autophagy and the Pathogenesis of Inflammatory Bowel Disease (IBD). Pharmaceuticals (Basel, Switzerland). Jul 22 2021;14(8)doi:10.3390/ph14080708
  3. Raman M, Ghosh S. Diet and Nutrition in IBD-Progress and Gaps. Nutrients. Jul 27 2019;11(8)doi:10.3390/nu11081740
  4. Takakura W, Pimentel M. Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome – An Update. Front Psychiatry. 2020;11:664. doi:10.3389/fpsyt.2020.00664
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  6. Zhang Y, Liu L, Wei C, et al. Vitamin K2 supplementation improves impaired glycemic homeostasis and insulin sensitivity for type 2 diabetes through gut microbiome and fecal metabolites. BMC Med. May 5 2023;21(1):174. doi:10.1186/s12916-023-02880-0