{"title":"血清维生素D水平与老年炎症性肠病的长期风险：一项大规模前瞻性队列研究","authors":"Qian Zhang, Si Liu, Shengtao Zhu, Aifang Li, Xiujing Sun, Shanshan Wu, Shutian Zhang","doi":"10.1016/j.amjmed.2025.05.017","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Vitamin D is considered as a potential immunomodulator in inflammatory bowel disease development; however, emerging evidence remains inconsistent. We aimed to investigate the prospective association between serum vitamin D level and long-term risk of elderly-onset inflammatory bowel disease in a large-scale cohort.</p><p><strong>Methods: </strong>Participants without inflammatory bowel disease at enrollment from the UK Biobank were included. Baseline blood samples were collected and serum 25-hydroxyvitamin D (25[OH]D) levels were measured. Participants were classified as having vitamin D deficiency (< 50 nmol/L), insufficiency (50-75 nmol/L) or sufficiency (≥ 75 nmol/L) based on predefined cutoffs. Primary outcome was incident elderly-onset inflammatory bowel disease, including ulcerative colitis and Crohn disease. Hazard ratio (HR) and 95% confidence intervals (CIs) of related associations were determined using multivariable Cox regression.</p><p><strong>Results: </strong>Among 357,656 participants (mean age, 57.9±6.9 years), 196,499 (54.9%) and 121,035 (33.8%) had vitamin D deficiency and insufficiency, respectively. During a median 13.3 years follow-up, 1622 elderly-onset inflammatory bowel disease cases were identified. Compared with vitamin D sufficiency, no associations with vitamin D deficiency (HR = 0.91; 95% CI, 0.78-1.07) or insufficiency (HR = 0.86; 95% CI, 0.73-1.01) were observed for elderly-onset inflammatory bowel disease. Similarly, no associations with per 10 nmol/L increase of serum 25(OH)D were detected for elderly-onset inflammatory bowel disease (HR = 1.00; 95% CI, 0.98-1.03), ulcerative colitis (HR = 1.00; 95% CI, 0.97-1.03), or Crohn disease (HR = 1.01; 95% CI, 0.97-1.05). Compared with the lowest quartile, no associations with higher quartiles of serum 25(OH)D were observed for inflammatory bowel disease (HR<sub>Q4VSQ1</sub> = 1.03; 95% CI, 0.89-1.19), ulcerative colitis (HR<sub>Q4VSQ1</sub> = 1.06; 95% CI, 0.90-1.26), or Crohn disease (HR<sub>Q4VSQ1</sub> = 0.93; 95% CI, 0.73-1.20). Further sensitivity and subgroup analyses demonstrated similar results.</p><p><strong>Conclusions: </strong>Serum vitamin D level or deficiency status is not associated with the development of elderly-onset inflammatory bowel disease, ulcerative colitis, or Crohn disease.</p>","PeriodicalId":50807,"journal":{"name":"American Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Serum Vitamin D Levels and Long-Term Risk of Elderly-Onset Inflammatory Bowel Disease: A Large-Scale Prospective Cohort Study.\",\"authors\":\"Qian Zhang, Si Liu, Shengtao Zhu, Aifang Li, Xiujing Sun, Shanshan Wu, Shutian Zhang\",\"doi\":\"10.1016/j.amjmed.2025.05.017\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Vitamin D is considered as a potential immunomodulator in inflammatory bowel disease development; however, emerging evidence remains inconsistent. We aimed to investigate the prospective association between serum vitamin D level and long-term risk of elderly-onset inflammatory bowel disease in a large-scale cohort.</p><p><strong>Methods: </strong>Participants without inflammatory bowel disease at enrollment from the UK Biobank were included. Baseline blood samples were collected and serum 25-hydroxyvitamin D (25[OH]D) levels were measured. Participants were classified as having vitamin D deficiency (< 50 nmol/L), insufficiency (50-75 nmol/L) or sufficiency (≥ 75 nmol/L) based on predefined cutoffs. Primary outcome was incident elderly-onset inflammatory bowel disease, including ulcerative colitis and Crohn disease. Hazard ratio (HR) and 95% confidence intervals (CIs) of related associations were determined using multivariable Cox regression.</p><p><strong>Results: </strong>Among 357,656 participants (mean age, 57.9±6.9 years), 196,499 (54.9%) and 121,035 (33.8%) had vitamin D deficiency and insufficiency, respectively. During a median 13.3 years follow-up, 1622 elderly-onset inflammatory bowel disease cases were identified. Compared with vitamin D sufficiency, no associations with vitamin D deficiency (HR = 0.91; 95% CI, 0.78-1.07) or insufficiency (HR = 0.86; 95% CI, 0.73-1.01) were observed for elderly-onset inflammatory bowel disease. Similarly, no associations with per 10 nmol/L increase of serum 25(OH)D were detected for elderly-onset inflammatory bowel disease (HR = 1.00; 95% CI, 0.98-1.03), ulcerative colitis (HR = 1.00; 95% CI, 0.97-1.03), or Crohn disease (HR = 1.01; 95% CI, 0.97-1.05). Compared with the lowest quartile, no associations with higher quartiles of serum 25(OH)D were observed for inflammatory bowel disease (HR<sub>Q4VSQ1</sub> = 1.03; 95% CI, 0.89-1.19), ulcerative colitis (HR<sub>Q4VSQ1</sub> = 1.06; 95% CI, 0.90-1.26), or Crohn disease (HR<sub>Q4VSQ1</sub> = 0.93; 95% CI, 0.73-1.20). Further sensitivity and subgroup analyses demonstrated similar results.</p><p><strong>Conclusions: </strong>Serum vitamin D level or deficiency status is not associated with the development of elderly-onset inflammatory bowel disease, ulcerative colitis, or Crohn disease.</p>\",\"PeriodicalId\":50807,\"journal\":{\"name\":\"American Journal of Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-05-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amjmed.2025.05.017\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amjmed.2025.05.017","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Serum Vitamin D Levels and Long-Term Risk of Elderly-Onset Inflammatory Bowel Disease: A Large-Scale Prospective Cohort Study.
Background: Vitamin D is considered as a potential immunomodulator in inflammatory bowel disease development; however, emerging evidence remains inconsistent. We aimed to investigate the prospective association between serum vitamin D level and long-term risk of elderly-onset inflammatory bowel disease in a large-scale cohort.
Methods: Participants without inflammatory bowel disease at enrollment from the UK Biobank were included. Baseline blood samples were collected and serum 25-hydroxyvitamin D (25[OH]D) levels were measured. Participants were classified as having vitamin D deficiency (< 50 nmol/L), insufficiency (50-75 nmol/L) or sufficiency (≥ 75 nmol/L) based on predefined cutoffs. Primary outcome was incident elderly-onset inflammatory bowel disease, including ulcerative colitis and Crohn disease. Hazard ratio (HR) and 95% confidence intervals (CIs) of related associations were determined using multivariable Cox regression.
Results: Among 357,656 participants (mean age, 57.9±6.9 years), 196,499 (54.9%) and 121,035 (33.8%) had vitamin D deficiency and insufficiency, respectively. During a median 13.3 years follow-up, 1622 elderly-onset inflammatory bowel disease cases were identified. Compared with vitamin D sufficiency, no associations with vitamin D deficiency (HR = 0.91; 95% CI, 0.78-1.07) or insufficiency (HR = 0.86; 95% CI, 0.73-1.01) were observed for elderly-onset inflammatory bowel disease. Similarly, no associations with per 10 nmol/L increase of serum 25(OH)D were detected for elderly-onset inflammatory bowel disease (HR = 1.00; 95% CI, 0.98-1.03), ulcerative colitis (HR = 1.00; 95% CI, 0.97-1.03), or Crohn disease (HR = 1.01; 95% CI, 0.97-1.05). Compared with the lowest quartile, no associations with higher quartiles of serum 25(OH)D were observed for inflammatory bowel disease (HRQ4VSQ1 = 1.03; 95% CI, 0.89-1.19), ulcerative colitis (HRQ4VSQ1 = 1.06; 95% CI, 0.90-1.26), or Crohn disease (HRQ4VSQ1 = 0.93; 95% CI, 0.73-1.20). Further sensitivity and subgroup analyses demonstrated similar results.
Conclusions: Serum vitamin D level or deficiency status is not associated with the development of elderly-onset inflammatory bowel disease, ulcerative colitis, or Crohn disease.
期刊介绍：
The American Journal of Medicine - "The Green Journal" - publishes original clinical research of interest to physicians in internal medicine, both in academia and community-based practice. AJM is the official journal of the Alliance for Academic Internal Medicine, a prestigious group comprising internal medicine department chairs at more than 125 medical schools across the U.S. Each issue carries useful reviews as well as seminal articles of immediate interest to the practicing physician, including peer-reviewed, original scientific studies that have direct clinical significance and position papers on health care issues, medical education, and public policy.
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