Association between vitamin D and fatigue in patients with rheumatoid arthritis: a cross-sectional study

Abstract

ObjectivesIn rheumatoid arthritis (RA), fatigue is an important complaint with a significant impact on quality of life. Vitamin D has modulatory effects on cells of the immune system and may potentially affect RA disease activity and thereby RA-related fatigue. The purpose of this study was to explore associations between fatigue and vitamin D status in patients with RA.DesignHypothesis-generating cross-sectional study.SettingScheduled follow-up visits at a hospital-based general rheumatology clinic.ParticipantsPatients (n=169) with established RA.Primary outcome measures and anlysesFatigue, assessed by the Chalder fatigue questionnaire, and serum concentrations of 25-hydroxyvitamin D (25(OH)D), assessed by liquid chromatography–tandem mass spectrometry. Associations were analysed by correlation, and multivariate linear regression with adjustments for age, sex, body mass index, RA disease activity as measured by the Disease Activity Score 28-joint count C reactive protein (DAS28-CRP), psychological distress, pain and sleep. Fatigue was also compared across four groups based on the levels of serum 25(OH)D with cut points at 30, 50 and 75 nmol/L using one-way analysis of variance.ResultsTwo-thirds of the patients (116/169, 69%) were classified with low RA disease activity, that is, a DAS28-CRP score below 3.2. Their mean (SD) serum 25(OH)D concentration was 56.3 (21.2) nmol/L, with 77 (45.6%) having values below 50 nmol/L and 12 patients (7.1%) below 30 nmol/L. The correlation between fatigue and serum concentrations of 25(OH)D was weak and not statistically significant, r = −0.14 (95% CI: −0.29 to 0.03, p=0.08). In the multivariate model, fatigue was significantly associated with RA disease activity, psychological distress and pain, but not with serum 25(OH)D. Fatigue did not differ across groups with varying levels of serum 25(OH)D.ConclusionThis cross-sectional study found no evidence of association between vitamin D and fatigue in patients with RA.

Vitamin D and Its Role on the Fatigue Mitigation: A Narrative Review

“…Roy et al (2014) recommend a plasma vitamin D test in patients with symptoms of fatigue as low serum vitamin D level is generally recognized in these patients, and a significant reduction in fatigue severity was reported after its correction [75]. In contrast, Jelsness-Jørgensen et al (2020) stated that in rheumatoid arthritis, there is no correlation between fatigue and plasma vitamin D levels [76].…”

Community-Dwelling Adults' Perceived Versus Actual Risk of Cardiovascular Disease, Body Mass Index, and Physical Activity Levels and Related Factors

“…1,25,35,36 Adults' perceptions about their health risks may impact their health promotion behaviors. 17,26,37 Those portraying a pessimistic outlook, overestimating their risks may seek frequent checkups while optimists who underestimate their risks may not engage in any health-promoting behavior. 18 The ideal is for individual perceptions to be in concordance with their actual risks.…”

“…To be able to compare the individuals' actual risk levels and their perceived risk levels, 3 questions were asked for the purpose of assessing their perceptions about CVD risk, BMI, and PA. In line with the literature, 17,26,31 the participants were asked to define their level of CVD risk for the next 10 years. The responses were measured according to the HeartScore classification of low risk, moderate risk, high risk, and very high risk.…”

“…For this reason, it is essential to evaluate whether the risk perception of this age group is compatible with reality and keep it at the actual level. 17,26 The concordance or discrepancy between individuals' real and perceived CVD risk levels and risk factors and identifying the factors responsible for a distorted perception is important to consider in raising awareness about CVD risk and which groups and precautions must be prioritized. In this study, we sought to evaluate the degree to which the 10-year risk estimations of adults living in a community agreed with actual CVD risk estimates.…”

“…In previous studies conducted in this age group, it has been determined that individuals are not aware of their CVD risks. 6,12,17,18,26 Individuals who can evaluate their risks correctly can take them under control. For this reason, it is essential to evaluate whether the risk perception of this age group is compatible with reality and keep it at the actual level.…”