Prevalence of Vitamin D Deficiency and Its Association with Disease Activity among Libyan Patients with Inflammatory Bowel Disease

Abstract

Vitamin D deficiency is a recognized non-skeletal concern in patients with inflammatory bowel disease (IBD) due to its immunomodulatory roles. However, regional data on vitamin D status in North African IBD cohorts, particularly in Libya, remain scarce. This study aimed to evaluate the prevalence of low serum 25-hydroxyvitamin D (25(OH)D) levels in Libyan IBD patients and examined its association with disease activity state. A cross-sectional study was conducted involving 71 adult IBD patients and 20 age-, sex-, and BMI-matched healthy controls. Demographic, clinical, and laboratory data, including serum 25(OH)D, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), were collected. Disease activity (active flare vs. clinical remission) was evaluated using a composite assessment of clinical symptoms, medical records, laboratory biomarkers, and endoscopic findings. Statistical comparisons were performed using Mann-Whitney and Fisher’s exact tests. The IBD cohort had a mean age of 36.35 ± 15.78 years and a mean BMI of 25.51±4.54 kg/m2. Results revealed a high prevalence of vitamin D deficiency among the IBD cohort, where 86% of patients presented with suboptimal vitamin D levels (serum 25(OH)D < 30 ng/ml) and exhibited substantially lower levels (mean 20.32 ng/ml) compared to controls (mean 31.20 ng/ml) (p < 0.0001).  A statistically significant association between active disease state and lower vitamin D levels compared to remission periods (median 16.90 ng/mL vs 21.50 ng/mL, p < 0.05) with patients presenting with active disease having nearly six-fold increased odds of vitamin D deficiency than those in remission. In conclusion, suboptimal vitamin D status is highly prevalent among IBD patients in Misurata, Libya, with disease activity acting as the primary driver of vitamin D depletion regardless of patient gender, underscoring the critical need for continuous assessment and the implementation of effective supplementation strategies to improve therapeutic outcomes across all IBD cohorts.