SAT0085 The Role of Vitamin D and Disease Activity in Rheumatoid Arthritis Pacients
Authors: S. Stoica, G. Zugravu
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Vitamin D plays an important role in immune regulation. There are a lot of studies which prove that vitamin D deficiency may be a risk for development of autoimmune diseases [1,3,6]. Preliminary studies suggest that low levels of vitamin D may be common in rheumatoid arthritis (RA) [2,5,7]. <h3>Objectives</h3> The aim of this study is to estimate the prevalence of vitamin D deficiency in patients with RA, and to analyze the association of vitamin D with disease activity and disability. <h3>Methods</h3> The study includes 52 RA premenopausal women aged between 35- 48 years, 32,7 % (17 pacients) with vitamin D supplements. Clinical evaluation included: disease onset and duration, presence of extraarticular manifestations, 28 tender joint count (TJC28) and 28 swollen joint count (SJC28), Disease Activity Score (DAS 28) was calculated using C-reactive protein (CRP), Health Assessment Questionnaire Disability Index (HAQ). RA specific treatment included the glucocorticoids, disease modifying antirheumatic drugs (DMARDs: methotrexate, cyclosporine, sulfasalazine, antimalarials, and azathioprine) and biologic therapy (anti-TNF or no). Exposure to sunlight from March to September (sun exposure time) was quantified as &lt;10, 10 to 20, 20 to 30 or &gt;30 minutes daily. Laboratory assessment included: rheumatoid factor (RF), anti Cyclic Citrullinated Peptide (anti-CCP), routine biochemistry, CRP, ESR and 25(OH)D level (25(OH)D level &lt;30 ng/ml was considered as vit D deficiency). <h3>Results</h3> A total of 67,3 % of RA patients were not taking vitamin D supplements; the proportion of these with vitamin D deficiency (25(OH)D level &lt;30 ng/ml) was 68%. In non-supplemented RA patients, 25(OH)D levels were negatively correlated with the Health Assessment Questionnaire Disability Index, Disease Activity Score (DAS28). In patients not taking vitamin D supplements, a significant negative correlation between 25(OH)D serum levels and age was observed (<i>P</i> &lt; 0.05), and mean values from June to December were significantly higher than from January to May (24.5 versus 18.0 ng/ml, respectively). Significantly lower 25(OH)D values were found in patients not experiencing disease remission or with DAS28 &gt;5.1 or poorlyresponding to treatment. Vitamin D deficiency was found in 56% of the entire cohort. <h3>Conclusions</h3> Vitamin D deficiency is common in RA patients. Patients with very active disease are at higher risk of vitamin D deficiency rather than the other. Patients with uncontrolled RA and/or with severe functional impairment are less prone to spend time outdoors in sunshine and are, therefore, at higher risk of vitamin D deficiency. <h3>References</h3> Holick MF: Vitamin D deficiency <i>N Engl J Med</i>2007, 357:266-281. PubMed Abstract Holick MF: Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. <i>Am J Clin Nutr</i>2004, 80:1678S-1688S. PubMed Abstract Jones G, Strugnell SA, DeLuca HF: Current understanding of the molecular actions of vitamin D. <i>Physiol Rev</i>1998, 78:1193-1231. PubMed Abstract Arnson Y, Amital H, Shoenfeld Y: Vitamin D and autoimmunity: new aetiological and therapeutic considerations <i>Ann Rheum Dis</i>2007, 66:1137-1142. PubMed Abstract <h3>Disclosure of Interest</h3> None Declared