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AB0305 Lower Physical Activity is Associated with Vitamin D Deficiency in Rheumatoid Arthritis, Lupus Erythematosus and Osteoarthritis Patients
  1. A. Raczkiewicz,
  2. A. Bachta,
  3. M. Kulig,
  4. J. Swarowska-Knap,
  5. A. Juszkiewicz,
  6. B. Kisiel,
  7. M. Tł ustochowicz,
  8. W. Tł ustochowicz
  1. Military Institute Of Health Services, Warsaw, Warsaw, Poland

Abstract

Background Vitamin D insufficiency seems to predispose to hypertension, metabolic syndrome and heart failure in general population. A low 25(OH)D serum concentration was associated with lower physical activity level and depression in older people. There is limited data about such associations in patients with rheumatic diseases.

Objectives The aim of the study was to estimate the prevalence of vitamin D deficiency in inflammatory and noninflammatory rheumatic disorders and to assess the correlation between 25-hydroxyvitamin D (25(OH)D) serum concentration and hypertension, diabetes, coronary heart disease, hypercholesterolemia, physical activity and quality of life.

Methods 242 consecutive patients (161 with rheumatoid arthritis (RA), 33 with osteoarthritis (OA), 21 with systemic lupus erythematosus (SLE) and 27 with fibromyalgia (FM)) were included in the study.The patients completed Short Form 36 Health Survey (SF-36), HAQ disability index and Beck Depression Inventory and the self-assessment questionnaire about daily physical activity and sun exposure. Body mass index (BMI), serum 25(OH)D, calcium, phosphorus, creatinine and total cholesterol concentration have been measured in all patients. Disease Activity Score (DAS28) was used to evaluate disease activity in RA patients.

Results Vitamin D deficiency was found in 71.9% of all examined patients and the prevalence was similar in examined groups. We have found no correlation between age, sex, BMI, disease duration, the history of coronary heart disease, diabetes and hypertension and vitamin D deficiency. RA patients with hypertension and/or coronary heart disease had lower vitamin D concentration but the difference was not significant. In all examined groups, except fibromyalgia, the patients who declared regular physical activity had significantly higher serum vitamin D concentration than patients who exercised less frequently or not exercised at all (p=0,00003). Higher serum cholesterol concentration was observed in vitamin D deficient patients, but after exclusion of cases on glicocorticosteroid treatment the difference became insignificant (p=0.06).In RA patients there was a weak inverse correlation between serum vitamin concentration and DAS28, physical domains of SF-36 and HAQ. There was no correlation between vitamin D concentration and other indices of life quality, disability, pain and depression.

Conclusions Vitamin D deficiency is common in Polish patients with rheumatic diseases. Regular physical activity is associated with higher serum vitamin concentration in patients with rheumatic diseases. The possible association between metabolic syndrome and vitamin D deficiency in inflammatory connective tissue diseases needs further studies.

References

  1. Ford ES, Ajani UA, McGuire MC et al. Concentrations of serum vitamin D and the metabolic syndrome. Diabetes care 2005;28(5):1228-1230

  2. Oh J, Wang S, Felton S et al. 1,25(OH)2 vitamin D inhibits foam cell formation and suppress macrophage cholesterol uptake in patients with type 2 diabetes mellitus. Circulation 2009;20:687-698

  3. Gardhem P, Ringsberg KAM, Obrant KJ et al. Association between 25-hydroxyvitamin D levels, physical activity, muscle strength and fractures in the prospective population-based study of eldery women. Osteoporosis Int 2005;16: 1425-1431

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.2621

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