Background Vitamin D, because of its pleiotropic effect, is involved in many aspects of pathophysiology including calcium-phosphorus metabolism, cellular growth and differentiation and immune functions. Epidemiological studies suggest that deficiency of vitamin D may be a risk factor of many conditions including autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematosus [1,2]. There are reports showing an inverse relationship between vitamin D concentrations and measures of disease activity in early inflammatory arthritis . But some other data are conflicting .
Objectives To estimate the vitamin D status in patients with early arthritis and to find relationship with some relevant features of disease activity. To examine associations between 25(OH)D level and current treatment.
Methods The study participants were patients with the diagnosis of early arthritis (lasting <2years) hospitalized in the Dept. of Rheumatology University Hospital, Wroclaw, Poland. 25(OH)D was measured in serum samples using commercial ELISA kit, all the necessary data concerning disease activity were also collected. Functional status was derived from HAQ questionnaire. Patients were diagnosed as having vitamin D deficiency when serum level of 25(OH)D were under 30 ng/ml.
Results A total of 39 patients (31 women, 8 men,), mean age 45.2±16.8 years were included in the study. In analyzed group mean disease duration was 6.3±7.3 months. Estimated disease activity according to DAS28 had a mean value 4.8±1.4. Mean serum level of 25(OH)D was 18.1±9.4 ng/ml. Only 2 out of 39 patients had 25(OH)D level over 30 ng/ml, the rest had under 12 ng/ml (severe deficiency). There was no correlation between vitamin D level and parameters of disease activity (ESR, C reactive protein, DAS28, morphologic parameters of the peripheral blood) or functional status. There was also no differences in 25(OH)D serum concentrations among women and men. Analyzing the influence of the treatment on 25(OH)D levels, the levels was significantly higher in patients treated with sulphasalazin, compared to those not treated with any of the disease modifying antirheumatic drugs. The use of corticosteroids (mean dose of prednisone in the study group was 10.4±8.6 mg per 24h) did not influence the 25(OH)D serum level significantly.
Conclusions The prevalence of vitamin D deficiency among patients with early arthritis is very high. The appropriate treatment regiments seem to influence the serum 25(OH)D levels. In contrast to earlier reports with recent-onset inflammatory arthritis, in our study, there were no associations between 25(OH)D levels and disease activity.
Fletcher JM, Basdeo SAet al. Therapeutic use of vitamin d and its analogues in autoimmunity.Recent Pat Inflamm Allergy Drug Discov.2012 Jan 1;6(1):22-34.
Cutolo M, Pizzorni C, Sulli A. Vitamin D endocrine system involvement in autoimmune rheumatic diseases.Autoimmun Rev.2011 Dec;11(2):84-7.
Patel S, et al. Association between serum vitamin D metabolite levels and disease activity in patients with early inflammatory polyarthritis. Arthritis Rheum. 2007; 56(7):2143–9.
Craig SM, Yu F, Curtis JR, Alarcόn GS et al. Vitamin D status and its associations with disease activity and severity in African Americans with recent-onset rheumatoid arthritis.J Rheumatol.2010 Feb;37(2):275-81.
Disclosure of Interest None Declared
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