Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability

Abstract

IntroductionThe aim of this study was to estimate the prevalence and determinants of vitamin D deficiency in patients with rheumatoid arthritis (RA) as compared to healthy controls and to analyze the association between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability.MethodsThe study includes 1,191 consecutive RA patients (85% women) and 1,019 controls, not on vitamin D supplements, from 22 Italian rheumatology centres. Together with parameters of disease activity, functional impairment, and mean sun exposure time, all patients had serum 25(OH)D measured in a centralized laboratory.ResultsA total of 55% of RA patients were not taking vitamin D supplements; the proportion of these with vitamin D deficiency (25(OH)D level <20 ng/ml) was 52%. This proportion was similar to that observed in control subjects (58.7%). One third of supplemented patients were still vitamin D deficient. In non-supplemented RA patients 25(OH)D levels were negatively correlated with the Health Assessment Questionnaire Disability Index, Disease Activity Score (DAS28), and Mobility Activities of daily living score. Significantly lower 25(OH)D values were found in patients not in disease remission or responding poorly to treatment, and with the highest Steinbrocker functional state. Body mass index (BMI) and sun exposure time were good predictors of 25(OH)D values (P < 0.001). The association between disease activity or functional scores and 25(OH)D levels remained statistically significant even after adjusting 25(OH)D levels for both BMI and sun exposure time.ConclusionsIn RA patients vitamin D deficiency is quite common, but similar to that found in control subjects; disease activity and disability scores are inversely related to 25(OH)D levels.

Relationship between vitamin D3 level and rheumatoid arthritis patients attending Rizgary Teaching Hospital in Erbil city

“…30%, P = 0.006) in patient group than healthy controls. [23][24][25] Low vitamin D3 levels may be associated with higher incidence of RA, as has already been mentioned by Song, et al 26 Other research done in India 27 which the result was against my research results, Thirty-one patients had high disease activity (DAS-28 score>5.1), 32 patients had moderate disease activity (DAS28 score 3.2-5.1) and 17 patients had low disease activity (DAS-28 score <3.2). Vitamin D3 level in high disease activity group was significantly low compared to…”

Low Serum Vitamin D Levels in Egyptian Adults With Chronic Primary Immune Thrombocytopenia: A Single Center Study.

“…[22] who studied a comparable number of Egyptian SLE patients (40 SLE patients and 20 age and sex matched controls) and did not find significant correlation between vitamin D level and age or disease duration. And another study by Rossini et al [23] conducted on rheumatoid arthritis patients did not find an association between vitamin D level and disease duration. Also Dias de Castro et al [24] in their study on patients with Inflammatory Bowel Disease found no correlation between vitamin D and age or disease duration.…”

Dietary calcium intake in a cohort of elderly patients already in drug therapy for osteoporosis. Is it possible and how to modify the eating habits before calcium supplementation?

“…The questionnaire we used (Table 1) has been validated in an Italian population. 4 It is a questionnaire easy to use and fast. A score below 7 was indicative of inadequate calcium intake (<1000 mg/die) via the diet.…”