BackgroundPlenty of studies demonstrated the relationship between vitamin D and Juvenile idiopathic arthritis (JIA) disease activity [1,2].Others reported no relationship between 25(OH)D and disease activity [3,4]. The main source of vitamin D is endogenous vitamin D synthesis induced by sunlight exposure.ObjectivesThe aim of this study was to examine the status of vitamin D in children with JIA depending on the peculiarities of the disease and the season.Methods92 patients with JIA were examined. The median age of them was 10,5±1,7 years, from 1,8 to 17,6 years (55 female, 37 male). The serum level of vitamin D was measured through blood test by chemiluminescence method. The relationship between the level of vitamin D and disease activity was analyzed based on juvenile arthritis disease activity score (JADAS27).ResultsThe average level of vitamin D was 22,75±1,97ng/ml (corresponded to an insufficient level). It was not found relationship between the frequency of vitamin D deficiency and gender. Vitamin D status changed throughout the year from lowest value 19,52±1,61 ng/ml (in May) till the greatest value 29,62±2,49 ng/ml (in September). Significantly higher level of vitamin D was in September compared to most months (January, p=0,04; February, p=0,04; March, p=0,01; April, p=0,02; May, p=0,01; October, p=0,03; November, p=0,03; December, p=0,01). The geographical location of Kharkiv (Ukraine) is at 50o latitude. It was proved that UVB radiation above the 33° latitude is not intense enough for the synthesis of vitamin D during the whole year [5]. At the same time there was no significant relationship between the low level of vitamin D in serum and disease activity.ConclusionA decrease of vitamin D status were observed throughout the year. Despite the fact that in September was the highest level of vitamin D, the normal concentration was not reached. Seasons should be taken into account, but patients with JIA need supplementation of vitamin D all around the year.References[1] Szymańska-Kałuża J. Biernacka-ZielińskaM, Stańczyk J, Smolewska E. Vitamin D level in children with juvenile idiopathic arthritis and its correlation with clinical picture of the disease. Reumatologia. 2013;51:271–6. doi: 10.5114/reum.2013.37250.[2] çomak E, Doğan çS, Uslu-gökçeoğlu A, Akbaş H, özdem S. Association between vitamin D deficiency and disease activity in juvenile idiopathic arthritis. Turk J Pediatr. 2014;56:626–631.[3] Dağdeviren-çakır A, Arvas A, Barut K, Gür E, Kasapçopur ö. Serum vitamin D levels during activation and remission periods of patients with juvenile idiopathic arthritis and familial Mediterranean fever. Turk J Pediatr. 2016;58:125–31. doi: 10.24953/turkjped.2016.02.001.[4] Bouaddi I, Rostom S, El Badri D, Hassani A, Chkirate B, Abouqal R, et al. Vitamin D concentrations and disease activity in Moroccan children with juvenile idiopathic arthritis. BMC Musculoskelet Disord. 2014;15:115. doi: 10.1186/1471-2474-15-115.[5] Wacker M, Holick MF. Sunlight and vitamin D: a global perspective for health. Dermatoendocrinol. ...

Îãëÿä ë³òåðàòóðè / Review of Literature ® Вступ Артрит є одним із найпоширеніших хронічних рев матичних захворювань у дітей. Термін «ювенільний ідіопатичний артрит» (ЮІА) застосовується для по значення групи захворювань, які поєднують хронічні артрити невідомої причини, що беруть свій початок у віці до 16 років. Етіологія ЮІА залишається невизначе ною, патогенез є багатофакторним. Одним із факторів ризику розвитку цього захворювання вважається недо статній рівень вітаміну D у сироватці крові. У зв'язку з цим останніми роками широко обговорюються дані про роль вітаміну D як імунного та запального медіа тора, що бере участь у патогенезі низки автоімунних захворювань (розсіяний склероз, діабет 1го типу, рев матоїдний артрит, системний червоний вовчак, хворо ба Крона), зокрема хронічного артриту, як у дорослих [1-3], так і у дітей [4-6]. У наш час доведено, що віта мін D є необхідним для активації та реагування клітин, що беруть участь у вроджених та адаптивних імунних реакціях, таких як макрофаги, дендритні клітини, Т та

Background:It is proved that rheumatic diseases are accompanied by pronounced changes in calcium-phosphorus metabolism, which underlies the development of osteopenia syndrome. If in previous years glucocorticosteroid therapy (GCS) was considered to be the main reason for this, then the role of pro-inflammatory agents (activity of the pathological process), provision with vitamin D (VitD), and the effect of basic therapy are currently being discussed. It is also known that a decrease blood level of vitamin D leads to a violation of the absorption of calcium and phosphorus, a further increase in the level of parathyroid hormone, which underlies the risk of a decrease in bone mineral density.Objectives:To study the level of parathyroid hormone in children with juvenile idiopathic arthritis, its relationship with the course of the disease and vitamin D status.Methods:91 patients with JIA (61 girls and 30 boys), with polyarticular (n = 41), oligoarticular (n = 29) and undifferentiated (n = 18) variants of JIA were examined. The age of the patients was 10.5 ± 1.7 years. The duration of the disease was 4.1 ± 1.1 years. All children receive basic methotrexate therapy. The control group included 25 peers of the corresponding gender. JADAS27 was counted, the levels of 25-hydroxycalciferol (25-OH D) and PTH were determined by chemiluminescent method. Corresponded to the content of vitamin D in blood serum, the normal level was noted in 14 patients, insufficiency - in 41 patients, deficiency - in 32 patients.Results:The level of PTH in children with JIA remained within physiological values (30.6 ± 2.1 pg/ml; from 12.7 to 61.8 pg/ml) despite the high frequency of a VitD decrease in blood (80.2%). The level of PTH was not significant in groups of patients with a different level of vitamin D (32.8 ± 2.1 pg/ml at deficiency group; 29.2 ± 2.4 pg/ml at insufficiency group; 29.1 ± 1.8 pg/ml at a normal level of VitD group). PTH was comparable and did not differ in children of different sexes.The highest level of PTH was in patients with a polyarticular variant of JIA (34.2 ± 4.5 pg / ml, p<0.05), which was accompanied by the lowest level of vitamin D (20.9 ± 2.1 ng / ml, p <0, 05) in the same group. There was obtained reliable correlations of activity indicators (JADAS27) taking into account Vit D and PTH, as well as with diseases duration and age of patients (p <0.05).Conclusion:A study of the level of PTH in children with JIA did not show a significant increase depending on the vitamin D status in these patients. However, the age-related state of PTH is associated with the activity of the pathological process, the prevalence of articular syndrome and prolonged illness.Disclosure of Interests:None declared