RESEARCH - Vitamin D deficiency in RA: prevalence, determinants, and associations with disease activity and disability

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Arthritis Res Ther. 2010 Nov 29;12(6):R216. [Epub ahead of print]

Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants

and associations with disease activity and disability.

Rossini M, Maddali Bongi S, La Montagna G, Minisola G, Malavolta N,

Bernini L, Cacace E, Sinigaglia L, Di Munno O, Adami S.

Rheumatology Unit, University of Verona, Piazzale Stefani 1, 37124

Verona, Italy.

Abstract

ABSTRACT:

INTRODUCTION: The aim of this study was to estimate the prevalence and

determinants of vitamin D deficiency in patients with rheumatoid

arthritis (RA) as compared to healthy controls and to analyze the

association between 25-hydroxyvitamin D (25(OH)D) with disease

activity and disability.

METHODS: The study includes 1,191 consecutive RA patients (85% women)

and 1,019 controls, not on vitamin D supplements, from 22 Italian

rheumatology centres. Together with parameters of disease activity,

functional impairment, and mean sun exposure time, all patients had

serum 25(OH)D measured in a centralized laboratory.

RESULTS: A total of 55% of RA patients were not taking vitamin D

supplements; the proportion of these with vitamin D deficiency

(25(OH)D level <20 ng/ml) was 52%. This proportion was similar to that

observed in control subjects (58.7%). One third of supplemented

patients were still vitamin D deficient. In non-supplemented RA

patients 25(OH)D levels were negatively correlated with the Health

Assessment Questionnaire Disability Index, Disease Activity Score

(DAS28), and Mobility Activities of daily living score. Significantly

lower 25(OH)D values were found in patients not in disease remission

or responding poorly to treatment, and with the highest Steinbrocker

functional state. Body mass index (BMI) and sun exposure time were

good predictors of 25(OH)D values (P < 0.001). The association between

disease activity or functional scores and 25(OH)D levels remained

statistically significant even after adjusting 25(OH)D levels for both

BMI and sun exposure time.

CONCLUSIONS: In RA patients vitamin D deficiency is quite common, but

similar to that found in control subjects; disease activity and

disability scores are inversely related to 25(OH)D levels.

PMID: 21114806

http://www.ncbi.nlm.nih.gov/pubmed/21114806

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