Clinical InvestigationVitamin D Serum Level, Disease Activity and Functional Ability in Different Rheumatic Patients
Section snippets
Subjects
Three groups of patients according to rheumatic diagnosis were consecutively enrolled from the outpatient clinics of 3 rheumatologic centers in Zagreb (Croatia) during a winter time (January-March). Two groups had inflammatory arthritis: PsA (38 patients: 19 men and 19 women), RA (53 patients: 4 men and 49 women), whereas the 3rd group consisted of patients with OA, a non-inflammatory rheumatic condition (29 patients: 5 men and 25 women).
The diagnosis of PsA, RA and OA were made according to
RESULTS
Age, clinical and laboratory parameters of patients with PsA, RA and OA are presented in Table 1. Patients with RA were significantly older than patients with PsA (P = 0.011), and patients with OA were significantly older than patients with PsA and RA (P < 0.001). Serum (25-OH)D level of < 75 nmol/L was found in 74% of patients with PsA, 94% of patients with RA and 97% of patients with OA. Vitamin D deficiency (≤ 25 nmol/L) was found in 13% of patients with PsA, 39% of patients with RA and 38% of
DISCUSSION
In this study, we wanted to analyze differences in the prevalence of vitamin D deficiency in patients with PsA, RA and OA and to explore its relationship with indices of disease activity and functional ability. In our sample of consecutive patients in outpatient rheumatology clinic, we showed that subjects with PsA, RA and OA have suboptimal levels of serum vitamin D. Vitamin D level was associated with disease activity only in the group of patients with PsA.
The association between vitamin D
CONCLUSIONS
In our patients attending general rheumatology clinic, low levels of serum vitamin D levels were found regardless of the type of rheumatic disease (inflammatory and noninflammatory). Comparing with RA, patients with PsA had significantly higher levels of serum vitamin D, and it was associated with disease activity. Their vitamin D level was also significantly associated with disease activity, which was not determined in patients with RA or OA. According to our data, routine prophylactic
ACKNOWLEDGMENTS
The authors thank Professor Maurizio Cutolo and Professor Alberto Sulli (from Research Laboratories and Clinical Academic Unit of Rheumatology, University of Genova, Italy) for reviewing the proposal of the study and for their incentive scientific advices.
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2017, Autoimmunity ReviewsCitation Excerpt :The deficiency of the “hormonal” active form of vitamin D and of its precursor 25(OH)D is extremely common, at least during winter, in all Europe and particularly in Northern countries like a “silent seasonal epidemic” [11]. Numerous studies from different continents and countries and their recent meta-analysis suggest significantly lower levels of vitamin D to be common in RA patients [10,34–36]. An inverse relationship between serum levels of vitamin D metabolites and disease activity or disability in RA patients has been reported [3,37].
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Supported in part by the Croatian Society of Rheumatology. The article has resulted from the work on the scientific project entitled “Psoriatic arthritis—Epidemiology and risk factors of progression,” supported by the Ministry of Science, Education and Sports, Republic of Croatia (Project No. 134-0000000-3531).
The authors have no conflicts of interest to disclose.