Vitamin D Deficiency May Increase Gastrointestinal Bleeding Risk in Patients on Blood Thinners
Study findings can raise awareness for both patients and health care providers about vitamin D deficiency as a potential contributor to bleeding risk, as well as lead to more personalized treatment approaches for patients on blood thinners.
Vitamin D deficiency may increase the risk of gastrointestinal bleeding (GIB) among patients using blood thinners, according to study findings presented at Digestive Disease Week 2024, held May 18 to 21 in Washington, DC.1
Yellow capsules representing the sun, a source of vitamin D / irissca - stock.adobe.com
Past research has proposed that vitamin D—an essential vitamin obtained from sun exposure, some dietary sources, and supplements2—might play a role in regulating thrombotic and anti-thrombotic mechanisms, as well as improving endothelial function. To add to this growing body of clinical literature and understand the interactions between vitamin D, blood clotting, and bleeding risk, investigators conducted a retrospective analysis investigating the association between vitamin D deficiency and GIB in patients using blood thinners.
Using the Epic Cosmos electronic data base, researchers assessed data of 2,878,278 patients on blood thinners with vitamin D deficiency and 16,290,436 patients on blood thinners without vitamin D deficiency between January 1, 2016, and January 1, 2024. Patient data was further stratified by different blood thinner categories, including aspirin, clopidogrel, warfarin, and direct oral anticoagulants.
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To isolate the specific effects of vitamin D deficiency on blood clotting, researchers assessed data both before and after excluding patients with potential confounding factors. These factors included end-stage renal disease, use of proton pump inhibitors/histamine-2 blockers, and current smoking history.
Notably, the rate of GIB was nearly double in the group with vitamin D deficiency (8.08%) compared to the group without vitamin D deficiency (4.76%), suggesting a possible association between deficiency and increased bleeding risk. Similar trends were observed across different blood thinner categories, further strengthening the suggestion that the association might not be specific to a particular blood thinner.
Even after excluding patients with potential confounding factors, the link between vitamin D deficiency and a higher risk of GIB persisted. Odds ratios, confidence intervals, and P values were statistically significant across all comparisons (P < .00001).
Although investigators observed a link between vitamin D deficiency and an increased risk of GIB in patients using blood thinners, causality cannot be established due to the retrospective nature of the study; more research is needed on the specific role that vitamin D deficiency and vitamin D supplementation have on the incidence of GIB. However, study findings can raise awareness for both patients and health care providers about vitamin D deficiency as a potential contributor to bleeding risk, as well as lead to more personalized treatment approaches for patients on blood thinners.
Click here for more of our coverage from Digestive Disease Week 2024.
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