Effect of vitamin D[3] supplementation on TNF-alpha serum level and disease activity index in Iranian IBD patients

ABSTRACT

The aim of the study was to assess the effectiveness of vitamin D[3] [1, 25[OH][2]D[3]] treatment in IBD with regard to tumor necrosis factor-alpha [TNF-alpha] serum level and clinical disease activity index [CDAI]. Vitamin D has immune-regulatory functions in experimental inflammatory bowel disease [IBD] and vitamin D deficiency is common in IBD patients. This was a randomized clinical trial on 108 IBD patients with serum 25-OHD levels less than 30ng/ml, which divided into vitamin D and control groups. Vitamin D group received 50000 IU vitamin D[3] for 12 weeks. Before and after the study, TNF-alpha and 25-OHD serum levels were measured by ELISA method. Data were analyzed using paired t-test, chi-square test and Spearman correlation coefficient. P-values less than 0.05 were considered statistically significant. Before the intervention no significant difference was found between baseline characteristics and TNF-alpha serum level of two groups. After intervention TNF-alpha serum level reduced but this reduction was not statistically significant [p=0.07, 95% CI -0.45 to 8.14]. The mean serum 25-OHD level of vitamin D increased from 15.54 to 67.89, which was statistically significant [p= 0.00, 95% CI -61.40 to -43.30]. TNF-alpha level was also associated significantly with CDAI before [Spearman's rho 0.3, p<0.0001] and after [Spearman's rho 0.27, P=0.01] intervention. Oral supplementation vitamin D[3] significantly increased serum vitamin D levels and insignificantly reduced serum TNF-alpha level. More studies with larger samples would be beneficial to assess vitamin D[3] supplementation efficient effect in IBD