S2946 Prevalence of Vitamin D Deficiency in Pediatric and Adult Patients With Inflammatory Bowel Disease: A Cross-Sectional Analysis

Introduction: Vitamin D deficiency is a known complication in inflammatory bowel disease (IBD), contributing to bone loss, growth impairment, and immune dysfunction. While adults with IBD are at increased risk of deficiency, there is limited comparative data on pediatric patients. Understanding differences in vitamin D status across age groups is critical for informing screening and management strategies. This study aims to compare the prevalence of vitamin D deficiency in pediatric versus adult IBD patients using a large national dataset. Methods: A retrospective cross-sectional analysis was performed using a national dataset of patients with IBD, stratified into pediatric (<18 years) and adult (≥18 years) groups. Each group was stratified based on the presence or absence of vitamin D deficiency, using International Classification of Diseases-10 codes. Adults and children without IBD served as the 2 comparison groups. Descriptive statistics, chi-square tests, and logistic regression analyses were used to estimate prevalence, calculate odds ratios (ORs), and adjust for potential confounders, including age, sex, race, obesity, smoking status, and Charlson comorbidity index. A P-value < 0.05 was considered statistically significant. Results: In adults, 5,171 of 185,918 IBD patients (2.78%) had vitamin D deficiency, compared to 1.58% of non-IBD adults (adjusted OR: 1.63; 95% CI: 1.53–1.74; P < 0.001). In pediatric IBD patients (n = 2,480), 87 (3.51%) had vitamin D deficiency, compared to 0.05% of non-IBD children (adjusted OR: 25.79; 95% CI: 16.02–41.50; P < 0.001). When comparing IBD patients directly, pediatric IBD patients were 1.27 times more likely to have vitamin D deficiency than adult IBD patients (OR: 1.27; P < 0.001). Conclusion: This large-scale analysis shows that pediatric IBD patients have a higher prevalence and relative risk of vitamin D deficiency than adults. The stronger association in children is particularly concerning, given vitamin D's role in immune regulation, gut barrier integrity, and microbiome balance—all critical in controlling intestinal inflammation. Deficiency in these areas may contribute to more severe disease and complications. These findings highlight the need for routine vitamin D screening and early supplementation in pediatric IBD to prevent growth impairment, bone fragility, and flares. Limitations include the retrospective design which may underestimate true deficiency rates. Future research should assess long-term outcomes of supplementation and optimal management strategies across the lifespan.