AB1292 PREVALENCE OF VITAMIN D DEFICIENCY AND ITS ASSOCIATED FACTORS AMONG RHEUMATOID ARTHRITIS PATIENTS MANAGED IN A RHEUMATOLOGY UNIT OF A TERTIARY CARE HOSPITAL IN SRI LANKA
Authors: sethuge silva, Gunendrika Kasthuriratna, Buddhika Mahesh, Janalini Sashikaran
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Prevalence of unrecognized vitamin D deficiency can be high among Rheumatoid Arthritis (RA) patients. Lack of mobility among of these patients prevent them receiving adequate sun exposure. Low levels of vitamin D could potentially cause a higher disease burden and disease activity. <h3>Objectives</h3> To determine the prevalence of vitamin D deficiency and its associated factors among RA patients managed in a rheumatology unit of National Hospital of Sri Lanka (NHSL). <h3>Methods</h3> A descriptive cross-sectional study was done among patients with RA with a calculated sample size of 137. Being diagnosed according to ACR – EULAR criteria and availability of serum vitamin D level were among the inclusion criteria. Patients with disability due to causes other than RA were excluded. All patients satisfying the eligibility criteria were invited to be recruited. A data extraction sheet was utilized. Data was collected by investigators. The associations were evaluated with Chi square test and Spearman correlation coefficient at a significance level of 5%. Ethics approval was obtained from ethics committee of NHSL. <h3>Results</h3> The response rate was 92%. The median (IQR) age of participants' were 56.5 (49.0 to 64.25). Among participants, majority (n=117, 92.9%) was females. Only 11.1% (n=14) had normal vitamin D levels. The insufficient and deficient categories comprised of 38.1% (n=48) and 50.8% (n=64). The commonest symptoms included; joint pain (n=101,80.2%), fatigue (n=84,66.7%) and muscle pain (n=78,61.9%). Deficiency or insufficiency was lowest in the occupation category of "agricultural and labourer" (37.5%) while 100% in many indoor-occupied categories and among Muslims. "Deficiency or insufficiency" was significantly associated with muscle pain (p=0.001) but not with CDAI (p=0.896), fatigue (p=0.549), joint pain (p=0.735). <h3>Conclusion</h3> Vitamin D "deficiency or insufficiency" is common among patients with RA and commoner in the sub-categories with muscle pain and with restricted sun-exposure. More research must be promoted in this regard. <h3>References</h3> [1] Imboden J.B., Hellmann D.B., Stone J.H. 2013. Current treatments and diagnosis rheumatology 3rd edition. New York : McGraw-Hill Medical [2] Baker JF, Baker DG, Toedter G, Shults J, Von Feldt JM, Leonard MB (2012) Associations between vitamin D, disease activity, and clinical response to therapy in rheumatoid arthritis. Clin Exp Rheumatol 30:658–664 2. [3] Braun-Moscovici Y, Toledano K, Markovits D, Rozin A, Nahir AM, Balbir-Gurman A (2011) Vitamin D level: is it related to disease activity in inflammatory joint disease? Rheumatol Int 31:493–499 [4] Craig SM, Yu F, Curtis JR, Alarcon GS, Conn DL, Jonas B, Callahan LF, Smith EA, Moreland LW, Bridges SL Jr, Mikuls TR (2010) Vitamin D status and its associations with disease activity and severity in African Americans with recent-onset rheumatoid arthritis. J Rheumatol 37:275–2812) [5] Haque UJ, Bartlett SJ (2010) Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. Clin Exp Rheumatol 28:745–747 5. <h3>Disclosure of Interests</h3> None declared