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Background Vitamin D deficiency is common in Poland. Epidemiological data suggest that it may be a risk factor for development or aggravation of autoimmune diseases. Some authors reported an inverse relationship between serum vitamin D metabolites concentration and disease activity, disability, pain and quality of life in patients with arthritis. Objectives The aim of the study was to estimate the prevalence of vitamin D deficiency in rheumatoid arthritis (RA) patients in Poland and to assess the correlation between 25-hydroxyvitamin D (25(OH)D) serum concentration and disease activity, treatment schedule, disability, quality of life and mood disturbances. Methods 113 RA patients (101 women,12men, mean age 59) were included in the study. Detailed information on previous treatment and vitamin D supplementation have been collected. The patients completed Short Form 36 Health Survey (SF-36), HAQ disability index and Beck Depression Inventory. Serum 25(OH)D, calcium, phosphorus and creatinine concentration have been performed in all patients. Disease Activity Score (DAS28) was used to evaluate disease activity. Results 17 (15%) patients (early RA) received no RA treatment Other patients were on methotrexate(≥15 mg/week) monotherapy (22;19.5%), methotrexate combined with low doses of prednisone (43;38.1%) and prednisone alone (31; 27.4%). Vitamin D deficiency (<20ng/mL) was found in 83 (73,5%) patients. The prevalence of vitamin D deficiency was comparable in patients on vitamin D supplementation and patients without supplementation. Mean serum 25(OH)D concentration in patients with low disease activity (DAS28<3.2) was higher than in patients with high disease activity (DAS28>5.2) (16,2ng/mL vs14ng/mL), and similarly mean DAS28 was higher in vitamin D-deficient patients than in patients with adequate vitamin D serum concentration (4,2 vs 3,9), but the differences were insignificant. The lowest 25(OH)D concentration was found in patients on prednisone monotherapy, the highest was observed in patients on methotrextate monotherapy (10,6 vs 17ng/mL; p=0,03). There was no correlation between vitamin D concentration and indices of life quality, disability, pain and depression. Conclusions Vitamin D deficiency is common in RA patients and the supplementation seems inadequate in this group of patients. Glicocorticosteroid therapy is associated with aggravation of vitamin D deficiency; on the other hand adequate DMARD therapy (without steroids) seems to have beneficial effect. The possible negative correlation between disease activity and vitamin D concentration needs further studies on larger groups of patients. References Rossini M, Maddali Bongi S, La Montagna G et al. Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability. Arthritis Research&Therapy 2010;12:R216 Cutolo M, Otsa K, Uprus M et al. Vitamin D in rheumatoid arthritis. Autoimmunity Reviews 2007;7:59-64 Antico A. Toampoia M, Tozzoli R et al. Can supplementation with vitamin D reduce the ri...

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