Vitamin D Status, Disease Activity, and Endothelial Dysfunction in Early Rheumatoid Arthritis Patients

Abstract

Cardiovascular diseases represent important complications in rheumatoid arthritis (RA) patients, generated by an accelerated atherosclerosis. The aim of this study is represented by the assessment of the correlations between serum levels of vitamin D, disease activity, and endothelial dysfunction in patients with early RA. Material and Methods. The study was performed on a group of 35 patients with early RA and 35 healthy subjects matched for age and gender, as controls. In all studied subjects, the following were determined: inflammatory markers, insulin resistance, vitamin D levels, and endothelial dysfunction. Statistical analysis were performed using the Student's t-test and the Pearson's test. p values of less than 0.05 were considered statistically significant. Results. The group of patients with RA patients presented inflammation, low levels of vitamin D, elevated insulin resistance, and reduced flow-mediated vasodilation, statistically significant compared to the control group (p < 0.00001). Significant inverse correlations between the levels of 25(OH) vitamin D and DAS28, respective insulin resistance, and significant positive correlation between 25(OH) vitamin D and endothelial function were demonstrated. Conclusion. In early RA patients with moderate and high disease activity, low serum levels of vitamin D were associated with disease activity, increased insulin resistance, and endothelial dysfunction.

Traditional and Non-Traditional Risk Factors Involved with Endothelial Dysfunction and Arterial Stiffness in Autoimmune Rheumatic Diseases

“…In agreement with these findings, current evidence demonstrates an important reduction in vascular endothelium-dependent vasodilatation, which is correlated with parameters of clinical disease activity [30]. Caraba et al [31] reported similar findings, demonstrating that disease activity is positively correlated with insulin resistance and endothelial dysfunction [31].…”

The relationship between epicardial adipose tissue and arterial stiffness in patients with rheumatoid arthritis

“…On the contrary, Beyazal et al found no impact of disease duration on vascular function [40]. Caraba et al reported significant associations between low serum levels of vitamin D and disease activity, increased insulin resistance, and endothelial dysfunction (assessed by flow-mediated vasodilation, on brachial artery, using B-mode ultrasonography) in early RA patients with moderate and high disease activity [41]. The relation between EAT and AS has been addressed in studies performed both in the general population, as well as in subgroups of patients with hypertension, cardiovascular disease, post-menopausal women or nonalcoholic fatty liver disease [13,[42][43][44], all reporting significant correlation.…”

Key Vitamin D Target Genes with Functions in the Immune System

“…VDR's first evolutionary function was the control of metabolism, in order to support the evolving immune system of ancestral vertebrates with energy [9]. Thus, VDR and its ligand first specialized in the modulation of innate and adaptive immunity, such as fighting against bacterial and viral infections [10,11] and preventing autoimmune diseases, such as multiple sclerosis and rheumatoid arthritis [12,13], before they took on the additional task of regulating bone metabolism. Thus, vitamin D deficiency is causing an increase in bone disease, such as rickets [14], and it may also be one of the reasons for increased vulnerability, particularly in elderly persons, against viral infections, such as the recent coronavirus (COVID-19) outbreak [15].…”