Assessment of Vitamin D in rheumatoid arthritis and its correlation with disease activity

Meena, Narendra Kumar; Chawla, Sumit; Garg, Ravinder; Batta, Anil; Kaur, Surinder

doi:10.4103/jnsbm.jnsbm_128_17

Cited by 47 publications

(7 citation statements)

References 26 publications

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“…[25] The study data also found a strong inverse correlation between 25 hydroxy vitamin D levels and RA disease activity, despite conflicting preliminary data. [26272829] However, recent studies among RA patients from India corroborate our findings, for instance in studies conducted by Sharma et al [30] ( n = 80), Meena et al [31] ( n = 50), and Borukar et al [32] ( n = 42), it was found that serum vitamin D levels were inversely correlated with DAS-28 scores.…”

Section: Discussionsupporting

confidence: 89%

Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis

Mukherjee

Lahiry

Thakur

et al. 2019

J Family Med Prim Care

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Background:To assess effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis (RA).Materials and Methods:An open-labeled randomized trial was conducted comparing 60,000 IU 1,25 dihydroxy vitamin D3 + calcium (1000 mg/day) combination [Group A] versus calcium (1000 mg/day) only [Group B], as supplement to existing treatment regimen in early RA. Primary outcome included (i) minimum time required for onset of pain relief (Tm) assessed through patients’ visual analog scale (VAS); (ii) % change in VAS score from onset of pain relief to end of 8 weeks. Secondary outcome included change in disease activity score (DAS-28).Results:At the end of 8-weeks, Group A reported 50% higher median pain relief scores (80% vs. 30%; P < 0.001) and DAS-28 scores (2.9 ± 0.6 vs. 3.1 ± 0.4; P = 0.012) compared to Group B; however, Tm remained comparable (19 ± 2 vs. 20 ± 2 days; P = 0.419). Occurrence of hypovitaminosis-D was lower (23.3%) compared to Indian prevalence rates and was a risk factor for developing active disease (Odds Ratio (OR) = 7.52 [95% Confidence Interval (CI) 2.67–21.16], P < 0.0001). Vitamin D deficiency was significantly (P < 0.001) more common in female gender, active disease, and shorter mean disease duration. Vitamin D levels were inversely correlated to disease activity as assessed by DAS-28 (r = –0.604; P < 0.001).Conclusions:Vitamin-D deficiency is a risk factor for developing active disease in RA. Weekly supplementation of 60,000 IU of 1,25 dihydroxy vitamin D3 in early RA results in greater pain relief. The number needed to treat for this additional pain relief was 2.Identifier:CTRI/2018/01/011532 (www.ctri.nic.in).

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Section: Discussionsupporting

confidence: 89%

Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis

Mukherjee

Lahiry

Thakur

et al. 2019

J Family Med Prim Care

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“…None of the subjects had ever used vitamin D supplement. Meanwhile, in the current study, we also found that RA disease activity was negatively correlated with vitamin D levels (data not shown), which coincides with the previous study [15]. However, we did not include data on physical activity levels in the analysis that influence vitamin D levels.…”

Section: Discussionsupporting

confidence: 90%

Correlation between Serum IL-35 Levels and Bone Loss in Postmenopausal Women with Rheumatoid Arthritis

Yao

Liu

et al. 2019

Mediators of Inflammation

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Objective. IL-35 was reported as a crucial anti-inflammatory cytokine and could efficiently regulate bone metabolism in murine collagen-induced arthritis model. However, the relationship between IL-35 and bone health in human rheumatoid arthritis (RA) has not been clarified. In this study, the aim was to explore the correlations between IL-35 and bone loss in postmenopausal women with RA. Methods. The study included 76 postmenopausal women with RA and 53 healthy postmenopausal women as healthy controls (HCs). Serum IL-35 levels were detected by enzyme-linked immunosorbent assay. Bone mineral density (BMD) at lumbar spine 1-4 and at total hip was measured using dual-energy X-ray absorptiometry. Alkaline phosphatase (ALP), β-isomerised carboxy-terminal cross-linking telopeptide of type I collagen (β-CTX), and 25-(OH) VitD3 were measured by turbidimetric inhibition immunoassay. Results. Serum IL-35 levels were increased compared with HCs, and it positively correlated with BMD and 25-(OH) VitD3 and negatively correlated with β-CTX in postmenopausal women with RA. Furthermore, serum IL-35 levels in the increased ALP group were higher than those in the normal ALP group. Conclusions. IL-35, an important anti-inflammatory cytokine, may participate in the pathogenesis of bone loss in postmenopausal women with RA.

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“…Merlino et al [ 130 ] showed in a prospective cohort study that women with highest tertile of vitamin D intake had a lower risk for developing RA by 33% compared with the lowest tertile. Some studies also reported the association between low serum 25(OH)D levels and higher disease activity in RA patients [ 131 , 132 , 133 ]. Although the association could simply be explained the fact that these patients tend to have limited physical outdoor activities and sunlight exposure, vitamin D and its metabolites are believed to have a therapeutic activity against RA based on the immunologic activities of 1,25(OH) 2 D that suppress T H 1 and T H 17 responses and enhance Treg activity [ 134 ].…”

Section: Vitamin D and Immune-related Diseasesmentioning

confidence: 99%

Immunologic Effects of Vitamin D on Human Health and Disease

2020

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Vitamin D is responsible for regulation of calcium and phosphate metabolism and maintaining a healthy mineralized skeleton. It is also known as an immunomodulatory hormone. Experimental studies have shown that 1,25-dihydroxyvitamin D, the active form of vitamin D, exerts immunologic activities on multiple components of the innate and adaptive immune system as well as endothelial membrane stability. Association between low levels of serum 25-hydroxyvitamin D and increased risk of developing several immune-related diseases and disorders, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19, has been observed. Accordingly, a number of clinical trials aiming to determine the efficacy of administration of vitamin D and its metabolites for treatment of these diseases have been conducted with variable outcomes. Interestingly, recent evidence suggests that some individuals might benefit from vitamin D more or less than others as high inter-individual difference in broad gene expression in human peripheral blood mononuclear cells in response to vitamin D supplementation has been observed. Although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40–60 ng/mL (100–150 nmol/L) to achieve the optimal overall health benefits of vitamin D.

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Assessment of Vitamin D in rheumatoid arthritis and its correlation with disease activity

Cited by 47 publications

References 26 publications

Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis

Effect of 1,25 dihydroxy vitamin D3 supplementation on pain relief in early rheumatoid arthritis

Correlation between Serum IL-35 Levels and Bone Loss in Postmenopausal Women with Rheumatoid Arthritis

Immunologic Effects of Vitamin D on Human Health and Disease

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