FRI0085 A study of the relationship between serum vitamin d level and disease activity in rheumatoid arthritis patients
Authors: S. Datta, A. Kar, T.K. Bhaumik, T. Santra
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Vitamin D is an essential component of our body. Approximately 3% of the human genome is directly or indirectly regulated by the Vitamin D endocrine system, which supports the idea that Vitamin D insufficiency has widespread adverse consequences for human health.<sup>[1]</sup>Till date several studies have been done regarding the relation of Vitamin D and Rheumatoid Arthritis but there are limited studies in Eastern India. Hence this study is being done to examine the relation of serum 25 hydroxy Vitamin D level and Disease Activity in Rheumatoid Arthritis patients. <h3>Objectives</h3> To examine the relationship between Serum 25 Hydroxy Vitamin D level and SDAI (Simplified Disease Activity Index) in Rheumatoid Arthritis patients. To examine the relationship between Serum 25 Hydroxy Vitamin D level and Tender Joint Count(TJC), Swollen Joint count(SJC) and CRP in Rheumatoid Arthritis patients. To evaluate the relation of serum vitamin D level with various socio demographic factors like Gender, Diet, Occupation, Season, Height, Weight, BMI in Rheumatoid Arthritis Patients. <h3>Methods</h3> Ninety six RA patients attending The Rheumatology clinic of Out Patient Department of An Urban Tertiary care hospital (Latitude of KOLKATA is 22<sup>0</sup>32<sup>'</sup>N) from October 2013 to September 2014, fulfilling the ACR –EULAR 2010 criteria for classification of RA, were included in the study. 25(OH)vitamin D levels were measured. Disease activity of RA was assessed by SDAI score. <h3>Results</h3> More than Ninety Percent of the RA patients were found to have either Vitamin D deficiency or insufficiency. The mean serum vitamin D level of these RA patients was 20.02 (±8.92) ng/ml. The RA patients with High Disease Activity (SDAI between 26.1 and 86) had significantly low (p&lt;0.0001) mean serum vitamin D level [11.11 (±6.08) ng/ml] than those with Moderate (SDAI between 11.1 and 26) or Low Disease Activity (SDAI between 3.4 and 11.0) whose serum vitamin D level was 21.15 (±7.47) ng/ml and 25.58 (±7.30) ng/ml respectively. There is a significant negative correlation between the Serum Vitamin D level and SDAI score (r=−0.669, p&lt;0.0001) in the whole group of the study population. However On analysing the data separately in RA patients with Vitamin D deficiency, insufficiency and sufficiency, this significant relation is separately evident only in the RA patients with Vitamin D deficiency (serum vitamin D level &lt;20 ng/ml) but not in those who were in the insufficient or sufficient groups. There is an independent negative impact of Simplified Disease Activity Index (SDAI) on Serum Vitamin D level (Adjusted R<sup>2=</sup>0.464, p&lt;0.0001). <h3>Conclusions</h3> RA patients having high disease activity in terms of SDAI Score had significantly low vitamin D level compared to patients of RA having low or moderate disease activity. Lower levels of serum vitamin D was associated with increased disease activity in RA patients. On subgroup analysis, there is significant negative correlation separately evident only in the RA patients with Vitamin D deficiency (serum vitamin D level &lt;20 ng/ml) but not in those who were in the insufficient or sufficient groups. <h3>Reference</h3> [1] Bouillon R, Carmeliet G, Verlinden L, et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev2008;29:726–776. <h3>Disclosure of Interest</h3> None declared