RESEARCH - Disease-specific definitions of vitamin D deficiency need to be established

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Arthritis Res Ther. 2010; 12(5): R191.

Published online 2010 October 14. doi: 10.1186/ar3161.

Disease-specific definitions of vitamin D deficiency need to be

established in autoimmune and non-autoimmune chronic diseases: a

retrospective comparison of three chronic diseases

R Broder,1 N Tobin,2,3 and Chaim Putterman1

1Division of Rheumatology, Albert Einstein College of

Medicine/Montefiore Medical Center, 1300 Park Avenue, Bronx, NY

10461, USA

2Department of Epidemiology and Population Health, Albert Einstein

College of Medicine, 1300 Park Avenue, Bronx, NY 10461, USA

3Clinical Directors Network (CDN), 5 West 37th Street, New York, NY 10018, USA

Abstract

Introduction

We compared the odds of vitamin D deficiency in three chronic

diseases: systemic lupus erythematosus (SLE), rheumatoid arthritis

(RA), and type 2 diabetes (T2DM), adjusting for medications,

demographics, and laboratory parameters, common to all three diseases.

We also designed multivariate models to determine whether different

factors are associated with vitamin D deficiency in different

racial/ethnic groups.

Methods

We identified all patients with non-overlapping diagnoses of SLE, RA,

and T2DM, with 25-hydroxyvitamin D (25OHD) levels measured between

2000 and 2009. Vitamin D deficiency was defined as 25OHD levels <20

ng/ml, based on previously established definitions. Race/ethnicity was

analyzed as African-American non-Hispanic (African-American), Hispanic

non-African-American (Hispanic), and Other based on self report.

Results

We included 3,914 patients in the final analysis: 123 SLE, 100 RA, and

3,691 T2DM. Among African-Americans the frequency of vitamin D

deficiency was 59% in SLE, 47% in RA, and 67% in T2DM. Among Hispanics

the frequency of vitamin D deficiency was 67% in SLE, 50% in RA, and

59% in T2DM. Compared with the SLE group, the adjusted odds ratio of

vitamin D deficiency was 1.1, 95% CI (0.62, 2.1) in the RA group, and

2.0, 95% CI (1.3, 3.1) in the T2DM group. In the multivariate

analysis, older age, higher serum calcium and bisphosphonate therapy

were associated with a lower odds of vitamin D deficiency in all three

racial/ethnic groups: 1,330 African-American, 1,257 Hispanic, and

1,100 Other. T2DM, serum creatinine, and vitamin D supplementation

were associated with vitamin D deficiency in some, but not all,

racial/ethnic groups.

Conclusions

Vitamin D deficiency is highly prevalent in our patients with SLE, RA,

and T2DM. While the odds of vitamin D deficiency are similar in RA and

SLE patients in a multivariate analysis, T2DM patients have much

higher odds of being vitamin D deficient. Different demographic and

laboratory factors may be associated with vitamin D deficiency within

different racial/ethnic groups. Therefore, disease-specific and

race/ethnicity-specific definitions of vitamin D deficiency need to be

established in future studies in order to define goals of vitamin D

replacement in patients with autoimmune and non-autoimmune chronic

diseases.

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Read the full article here:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2991026/?tool=pubmed

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