Article Text
Abstract
Background 25 (OH) Vitamin D deficiency is reported to be common in patients with rheumatoid arthritis (RA). It has been demonstrated in the Women's Iowa Health Study with data from 29,368 women that vitamin D intake was inversely associated with the risk of rheumatoid arthritis. This deficiency is also reported to be associated with disease activity and physical disability in patients with RA.(1-3)
Objectives To examine the prevalence of vitamin D insufficiency in patients with rheumatoid arthritis (RA) and its association with disease activity, severity and physical disability.
Methods We included patients with rheumatoid arthritis in department of rheumatology of Hassan II University Hospital, Fez, Morocco. Patients suffering from liver and kidney insufficiency and those administered Vitamin D in the previous 12 months have been excluded. Statistical analysis was done using SPSS v 18. A bivariate analysis and a logistic regression were used to identify factors associated with vitamin D deficiency.
Results One hundred seventy patients were included with a mean age of 50±12.1 [17-83] years and a female predominance (88.1%). All of our patients had hypovitaminosis D. The prevalence of 25(OH)-D insufficiency and deficiency was 64.5% and 35.5% successively. In unadjusted analysis, vitamin D concentration was inversely associated with pain visual analog scale VAS score (p<0.001), asthenia VAS (p<0.001),morning stiffness (p=0.03),number of Tender joints (p=0.004), number of Swollen joints (p<0.001),inflammatory markers (p=0,012), Disease Activity Score (p=0.009), physical disability using Health Assessment Questionnaire (HAQ) (p=0.001), and severity of the disease (p<0.001). After logistic regression persisted association with female sex (OR =4.3, CI = [0.94 to 20.976], p=0.05), asthenia VAS (OR =1.029, CI = [1.011 to 1.046], p=0.001), and with the severity of the disease (OR =2.910, CI = [1.314-6.441], p=0.008).
Conclusions The vitamin D deficiency is common in our patients with RA. This deficiency is associated with female sex, severe asthenia and the severity of the disease.
References
Merlino LA, Curtis J, Mikuls TR, CerhanJR, Criswell LA, Saag KW (2004) Iowa Women's Health Study Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women's Health Study. Arthritis Rheum 50:72–77.
Craig SM, Yu F, Curtis JR, Alarcon GS, Conn DL, Jonas B, Callahan LF, Smith EA, Moreland LW, Bridges SL Jr, Mikuls TR (2010) Vitamin D status and its associations with disease activity and severity in African Americans with recent-onset rheumatoid arthritis. J Rheumatol37:275–281.
Haque UJ, Bartlett SJ (2010) Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. Clin Exp Rheumatol 28:745–747.
Disclosure of Interest None declared