RESEARCH - Vitamin D level: is it related to disease activity in inflammatory joint disease?

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Rheumatol Int. 2009 Dec 23.

Vitamin D level: is it related to disease activity in inflammatory

joint disease?

Braun-Moscovici Y, Toledano K, Markovits D, Rozin A, Nahir AM, Balbir-Gurman A.

B. Shine Department of Rheumatology, Rambam Health Care Campus,

Rappaport Faculty of Medicine, Technion-Israel Institute of

Technology, Haifa, Israel,

The objectives of this study are to assess the vitamin D status in

patients (pts) with inflammatory joint diseases (IJD), and its

correlation with disease activity. 121 consecutive pts (85 rheumatoid

arthritis (RA), 22 psoriatic arthritis (PSA), 14 ankylosing

spondylitis (AS)) underwent clinical and laboratory evaluation which

included kidney and liver function tests, serum calcium and phosphor

levels, 25(OH)D and parathyroid hormone (PTH). Disease activity was

assessed by DAS 28 in RA and PSA pts and by BASDAI in AS pts,

sedimentation rate (ESR) and CRP. According to activity indexes, pts

were divided into subgroups with low (DAS28 < 3.2 and BASDAI < 4), and

moderate-to-high disease activity (DAS28 > 3.2 and BASDAI > 4).

Associations between serum levels of 25(OH)D and age, gender,

ethnicity, type and disease duration, treatment, (anti-tumor necrosis

factoralpha (TNFalpha) agents or DMARDs), seasonal variations, and

disease activity were assessed. Vitamin D deficiency was found in 51

pts (42.1%). The incidence was higher among Arab pts (76.7%) compared

to Jews (23%). The difference of 25(OH)D levels between Arabs (mean

9.4 +/- 4.2 ng/ml) and Jews (mean 17.8 +/- 8.4 ng/ml) was

statistically significant (p < 0.0001). We did not find correlation

between vitamin D levels and the other evaluated factors.

A surprisingly high incidence of vitamin D deficiency was found in IJD

patients in a sunny Mediterranean country. This finding justifies the

inclusion of vitamin D in the routine lab work-up of pts with IJD. The

only statistical significant correlation was found between vitamin D

level and ethnic origin. Further studies are needed to look for

genetic polymorphism of vitamin D receptors.

PMID: 20033415

http://www.ncbi.nlm.nih.gov/pubmed/20033415

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