Published online Aug 7, 2018. doi: 10.3748/wjg.v24.i29.3293
Peer-review started: April 4, 2018
First decision: May 30, 2018
Revised: June 17, 2018
Accepted: June 27, 2018
Article in press: June 27, 2018
Published online: August 7, 2018
Fatigue is common in inflammatory bowel diseases (IBD) and is especially prevalent in active disease. Also sleep disturbance, anemia, pain and depression all seem to influence fatigue. However, a relationship between vitamin D and fatigue has not been established.
We wanted to investigate if vitamin D deficiency was associated to fatigue in IBD as this is a common belief among both patients and physicians. To the best of our knowledge, no previous studies have investigated this possible association in IBD patients.
A relationship between vitamin D and fatigue has not been established. We wanted to explore this association and discover possible implications for our patients and further research.
The research question was explored in a fairly large cohort of IBD patients from specialist care. The study was designed as an observational study, and all data were collected at inclusion. Linear and logistic regression models were applied to explore the possible association between vitamin D deficiency and total fatigue scores and chronic fatigue, respectively. All vitamin D analyses were done at the same laboratory.
In this study fatigue was commonly reported. Vitamin D levels were, however, neither associated with total fatigue nor with chronic fatigue. Higher total fatigue scores and chronic fatigue were both associated with increased disease activity scores, but not with objective markers of inflammation. Sleep disturbance and depressive symptoms were associated with total fatigue scores in both ulcerative colitis and Crohn’s disease (CD) patients, but with chronic fatigue only in CD patients.
In this study, fatigue was associated with clinical disease activity, depression and sleep disturbance. Our data did not reveal any association between vitamin D deficiency and fatigue, supporting a multidimensional approach in the understanding of fatigue.
The possible associations we report need to be explored in further clinical studies. A randomized controlled trial with an interventional group receiving vitamin D supplementation may shed light on the possible benefits of vitamin D in patient reported outcomes in IBD.