Objectives To study the association between vitamin D levels and the clinical characteristics of patients with chronic inflammatory rheumatic diseases (CIRD).
Methods Analysis of data from the baseline visit of the CARMA project (CARdiovascular in rheuMAtology); a 10-year prospective study evaluating the risk of cardiovascular events in a cohort of rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients, and a cohort of unexposed matched individuals who attended rheumatology outpatient clinics from 67 hospitals in Spain. Sociodemographic characteristics, comorbidities, and disease activity of CIRD were analyzed. Patients were defined as having vitamin D deficiency if 25-OH vitamin D levels were <20 ng/ml
Results 2.234 patients (775 RA, 738 AS and 721 PsA) and 677 unexposed subjects were assessed. The median [p25-p75] 25-OH vitamin D levels were: 20.4 [14.4-29.2] ng/ml in RA, 20.9 [13.1-29.0] in AS, 20.0 [14.0-28.8] in PsA and 24.8 [18.4-32.6] ng/ml in unexposed controls. Vitamin D deficiency was detected in 40.5% RA, 39.7% AS, 40.9% PsA and 26.7% unexposed cohort (p<0.001). A positive association between CIRD and vitamin D deficiency was found: adjusted (adj.) OR=2.28 (95% CI=1.77-2.93) in RA, 1.94 (95% CI=1.44-2.60) in AS and 1.99 (95% CI=1.54-2.58) in PsA (p<0.001). A significant association between vitamin D deficiency and anti-cyclic citrullinated peptide antibodies (ACPA) in RA and BASFI in AS was also found. However, no association between vitamin D deficiency and other disease parameters was observed.
Conclusions Patients with CIRD show an increased risk of having vitamin D deficiency compared to unexposed matched individuals. ACPA and BASFI were the main factors associated with vitamin D deficiency in RA and AS, respectively
Disclosure of Interest A. Urruticoechea Arana: None declared, M. A. Martin Martinez: None declared, S. Castañeda: None declared, C. A. Piedra: None declared, C. Gonzalez Juanatey: None declared, J. Llorca: None declared, F. Diaz Gonzalez: None declared, M. A. Gonzalez-Gay Grant/research support from: This project has been supported by an unrestricted grant from Abbvie, Spain. The design, analysis, interpretation of results and preparation of the manuscript has been done independently of Abbvie. Dr. González-Gay's studies have been supported by grants from “Fondo de Investigaciones Sanitarias” PI06/0024, PS09/00748 and PI12/00060, and RD12/0009/0013 (RIER) from “Instituto de Salud Carlos III” (ISCIII) (Spain).