Vitamin D levels in juvenile idiopathic arthritis from an equatorial region

Abstract

We aimed to describe the serum levels of 25-hydroxyvitamin D (25OHD) in juvenile idiopathic arthritis (JIA) patients living in a low-latitude (3°43'S) region. Fifty JIA patients, 31 (62 %) female, seen between May 2012 and April 2013 in the northeast of Brazil had clinical data and serum collected for determination of 25OHD and parathyroid hormone (PTH) using a chemiluminescent ELISA; 20 age- and sex-matched controls were used for comparison. Mean age was 13.4 ± 4 years. Twenty-five (50 %), 15 (30 %), 4 (8 %), 4 (8 %), and 2 (4 %) patients were of the polyarticular, oligoarticular, systemic, enthesitis-related, and undifferentiated categories, respectively. Mean 25OHD was 31.6 ± 10 and 30.4 ± 5.7 ng/mL in patients and controls (P > 0.05), respectively; PTH was normal in JIA and controls; 25OHD was similar regardless of JIA category, disease activity, or severity measured by JADAS-27, CHAQ, or presence of joint deformities. Twenty-six (52 %), 20 (40 %), and 4 (8 %) patients were considered to have optimal, sufficient, and deficient 25OHD levels, respectively, whereas 11 (52 %) and 10 (48 %) controls had optimal and sufficient 25OHD. Ethnicity, body mass index, seasonal variation, and use of steroids did not influence 25OHD levels. This is the first study on 25OHD levels in JIA patients living in a low-latitude region, showing the lowest prevalence of vitamin D deficiency ever reported. Serum 25OHD was similar in JIA and controls and did not vary regardless of JIA category or severity.

Prevalence of Vitamin D Deficiency in Patients Treated for Juvenile Idiopathic Arthritis and Potential Role of Methotrexate: A Preliminary Study

“…Surprisingly, the prolonged use of GCs in our patients was not associated with a decrease in 25(OH)D concentration despite an evident inverse relationship between GCs and calcium or phosphate metabolism. Some studies support our results by demonstrating clearly that the use of systemic steroids does not influence 25(OH)D levels [28]. Other reports show, by contrast, that GCs may have a specific regulatory effect on vitamin D metabolism [19,29].…”

Level of 25-Hydroxyvitamin D in Pediatric Arthritis Patients

“…The average vitamin D level among patients included in our study was 25.26 ± 9.02 (8.17-52.71) ng/ml. In a comparative study of 50 JIA patients living in Brazil, the average vitamin D level was 31.6 ± 10.0 ng/ml, which was higher than in the control group of 30.4 ± 5.7 ng/ml (p > 0.05) (De Sousa Studart et al, 2015 level of 25(OH)D in patients with JIA than in the control group (p < 0.001). In JIA patients in Turkey, an average vitamin D level of 17.7 ± 11.6 ng/ml was observed (Çomak et al, 2014).…”

“…The available literature does not report any difference in vitamin D levels between JIA and ReA patients. De Sousa Studart et al (2015) found that vitamin D levels were higher in JIA patients than in a control group, which might be due to vitamin D substitution in the JIA patient group. In another study, patients with JIA showed statistically significant lower levels of 25 (OH) vitamin D compared to a control group (p < 0.001), which was also observed for different forms of JIA (oligoarticular formp < 0.05; polyarticular formp < 0.005; systemic formp < 0.001; enthesitis associated formp < 0.005) (Stagi et al 2014).…”

“…It is also possible that adipose patients have less exposure to direct sunlight due to reduced physical activity (Cheng et al, 2010;Ahmadieh et al, 2013). In some studies, no correlation was found between vitamin D levels and BMI (De Sousa Studart et al, 2015).…”

Modern concepts of vitamin D role in juvenile idiopathic arthritis in children (review)

“…, коли середній рівень у сироватці крові 25(ОН)D був в інтервалі від 50 до 75 нмоль/л[17,18, 20, 22, 25, 28, 29, 31, 32, 34, 35,[41][42][43] 50, 57] та п'ятнадцять (39,5 %) зазначали про наявність середніх показників 25(ОН)D нижче 50 нмоль/л[16, 19, 21, 24, 26, 27, 30, 33, 36, 38,[44][45][46], 52, 58], що розглядалося як дефіцитний станметі уточнення взаємозв'язку рівня вітамі ну D при збільшенні тривалості захворювання, його зміни на тлі рецидивів та залежності від частоти заго стрень. Така асоціація спостерігалась у дослідженні, яке включало 152 пацієнтів з ювенільними артритами, де було доведено значне зниження рівня 25(OH)D на тлі хвороби порівняно з групою контролю (що вклю чало 188 дітей, схожих за віком та статтю) [18].…”