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Effects of Calcium and Vitamin D Supplementation on Markers of Colonic Permeability

Impaired gut barrier function contributes to inflammatory bowel diseases and colorectal carcinogenesis. Recent evidence from experimental models indicates that calcium and vitamin D may beneficially modulate colonic permeability; however, to date, there are no reported human studies that investigated this hypothesis. To address this, we tested the effects of calcium (1.2 g/d) and/or vitamin D3 (1,000 IU/d) supplementation for 3 or 5 years on circulating biomarkers of colonic hyperpermeability (anti‐flagellin and anti‐lipopolysaccharide immunoglobulins [Igs], IgA and IgG) in 175 participants with previous colorectal adenoma from a recently completed, multi‐center, randomized, double‐blind, placebo‐controlled, modified 2 x 2 factorial chemoprevention clinical trial (NCT00153816). Igs were measured in plasma via ELISA. The relative change in a combined permeability score (CPS, defined as the sum of the optical densities of all biomarkers) from baseline to follow‐up was ‐2%, 1%, and 4% in the calcium, calcium plus vitamin D, and vitamin D groups vs. placebo, respectively (all P‐values > 0.5). At baseline, the CPS was higher among men (P = 0.02) and the severely obese (BMI >35 kg/m2; P = 0.002). Our preliminary results indicate no effect of calcium and vitamin D treatment on markers of colonic permeability, and suggest that men and those who are obese may have greater gut permeability.