AB1281-HPR THE LEVELS OF VITAMIN D IN THE SPONDYLOARTHRITIS. DOES THE DEFICIT CORRESPOND TO THE INFLAMMATORY ACTIVITY?
Authors: D. Castro-Corredor, M. A. Ramírez Huaranga, A. I. Rebollo Giménez, M. D. Mínguez Sánchez, J. Anino-Fernández, I. M. De Lara Simón, J. L. Cuadra Díaz
Journal: Annals of the Rheumatic Diseases (2020)

Background: Spondyloarthritis is a group of chronic inflammatory diseases with involvement of the axial skeleton (mainly), and also of peripheral joints. Patients with spondyloarthritis have a significant prevalence of vitamin D levels below normal and that would correlate with the degree of activity of the disease. Objectives: To determine the association between vitamin D deficiency and the degree of activity of the disease (inflammatory activity) in a cohort of patients with spondyloarthritis. Methods: Case-control type analytical observational study. We propose a retrospective review of the database of patients with spondyloarthritis (according ASAS2010 criteria) who were treated in the outpatient clinics of the Rheumatology Service of the General University Hospital of Ciudad Real during June 2018 to June 2019. Patients with the data will be selected. necessary for the analysis of the variables under study. The numerical variables of normal distribution evaluated will be described using measures of frequency and measures of central tendency / dispersion as appropriate. To assess the association between vitamin D levels and activity index, the odds ratio (OR) is calculated, with a 95% confidence level and the T-student for related samples. Results: The final results of the study are presented. 115 patients were analyzed, of which 64 were men and 51 women, with an average age of 45.97 years (+/- 13.41 DE). 47% were ankylosing spondylitis, 21% psoriatic arthropathy, 16% undifferentiated spondyloarthritis, 7% spondyloarthropathy associated with inflammatory bowel disease and 9% were spondyloarthropathy associated with inflammatory bowel disease. The average of the activity was a BASDAI of 4.57 (+/- 2.35 SD) and measured by DAPSA was 12.61 (+/- 6.76 SD). 63 and 14 patients had activity measured by BASDAI and DAPSA, respectively. 49.56% patients presented an elevation of acute phase reactants. Vitamin D levels were 23.81 (+/- 10.5 SD). 77.4% presented figures of vitamin D deficiency or insufficiency. When performing the association analysis, the vitamin D deficit / insufficiency presented an OR 10 (95% CI: 3.66-27.29, p=&lt;0.0001) with the degree of activity measured with BASDAI and DAPSA and against the elevation of RCP it was 3.63 (95% CI 1.43-9.25, p = 0.0092) and against the elevation of ESR it was 2.76 (95% CI 1.09-7, 0, p = 0.0438). Regarding the comparative analysis of means between vitamin D deficiency/insufficiency and BASDAI/DAPSA it was +3.29 (95% CI: 1.34-8.09, p=0.0084). Conclusion: Patients with spondyloarthritis, as in other autoimmune diseases, vitamin D deficiency is associated with increased inflammatory activity (BASDAI, DAPSA, RCP and ESR), measured in different time periods. Therefore, an optimization of vitamin D levels can imply an improvement in the patient’s clinical situation, measured by both BASDAI and DAPSA, as well as by RCP and ESR. In addition, it is necessary to monitor bone mineral density due to the risk of fracture in these patients for their multietiology (corticosteroid treatments, biological FAMEs, inflammatory activity). References: [1]Lange U, Teichmann J, Strunk J, Müller-Ladner U, Schmidt KL. Association of 1.25 vitamin D3 deficiency, disease activity and low bone mass in ankylosing spondylitis. Osteoporos Int. 2005;16:1999-2004. [2]Durmus B, Altay Z, Baysal O, Ersoy Y. Does vitamin D affect disease severity in patients with ankylosing spondylitis? Chin Med J. 2012;125:2511-2515. [3]Mermerci Baskan B, Pekin Dogan y, Sivas F, Bodur H, Ozoran K. The relation between osteoporosis and vitamin D levels and disease activity in ankylosing spondylitis. Rheumatol Int. 2010;30:375-381. Disclosure of Interests: None declared