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AB0530 25-Hydroxyvitamin D3 Deficiency: Prevalance and Its Impact on Disease Activity in Small-Medium Vessel Vasculitis
  1. F.N. Korkmaz1,
  2. G. Ozen2,
  3. A.U. Unal2,
  4. M. Can3,
  5. S. Tuglular4,
  6. H. Direskeneli2
  1. 1Internal Medicine
  2. 2Department of Rheumatology, Marmara University Faculty of Medicine
  3. 3Department of Rheumatology, Medipol University
  4. 4Department of Nephrology, Marmara University Faculty of Medicine, istanbul, Turkey

Abstract

Background Growing evidence suggests that vitamin D has important immunomodulatory effects and plays key roles in endothelial dysfunction, atherosclerosis and pathogenesis/progression of some of the inflammatory rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. Although recent data indicated that vitamin D deficiency is quite prevalant and affects endothelial dysfunction in Behcet's Disease and Takayasu's arteritis, vitamin D levels in small/ medium vessel vasculitis and its effects on disease course have not been evaluated.

Objectives To determine the prevalance of 25-hidroxyvitamin D3 [25(OH)D3] deficiency and to investigate its effects on disease activity in patients with small and/or medium vessel vasculitis.

Methods In this cross-sectional study, 25(OH)D3 levels were measured in adult patients with systemic small-medium vessel vasculitis including ANCA-associated vasculitis (AAV), cryoglobulinemic vasculitis (CryV), IgA vasculitis (IgAV) and polyarteritis nodosa (PAN), and sex-matched healthy subjects (HS). All patients' baseline demographics, disease characteristics, acute phase reactants, medications and disease extents (DEI), disease activities (BVAS) and damage scores (VDI) were determined. 25(OH)D3 level <30ng/ml and <20ng/ml were regarded as insufficiency and deficiency, respectively.

Results Forty five patients (29% new diagnosis) with systemic vasculitis and 63 HS were included (Table 1). The mean 25(OH)D3 level was 21.8±14.3 ng/mL in patients with vasculitis and 56.7±23.9 ng/mL in HS (p<0.001). Vitamin D insufficiency and deficiency were significantly higher in patients with vasculitis compared to HS (Table 1). Thirty eight patients (84.4%) were active (BVAS≥1) at the time of recruitment. 25(OH)D3 levels were not different in active (21.6±14.8) and inactive (23.1±12.1) patients (p=0.79). Of the 24 vitamin D deficient patients 23 (95.8%) had renal involvement. Vitamin D deficient patients had slightly higher BVAS (6.5±6.7 vs 3.7±3.7), VDI (3.8±1.4 vs 3.2±1.3) and DEI (3.0±2.8 vs 1.8±2.4) scores at recruitment but the differences were not statistically significant (p>0.05). Likewise there was no difference in acute phase reactants according to vitamin D status.

Conclusions Vitamin D insufficiency and deficiency are quite common in patients with small/medium vessel systemic vasculitis. In this preliminary study we could not demonstrate any association with vitamin D deficiency and disease activity in patients with vasculitis. However, prospective followup of a larger sample would better clarify the role of vitamin D on disease activity. Considering also the use of high dose glucocorticoid treatment, these patients should be adequately evalauted and treated for vitamin D deficiency.

Disclosure of Interest None declared

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