Relationship between vitamin D3 level and rheumatoid arthritis patients attending Rizgary Teaching Hospital in Erbil city
Keywords:Rheumatoid arthritis, Vitamin D3, DAS28, CDAI
Background and objective: Rheumatoid arthritis (RA) is an autoimmune disease of unknown etiology. Vitamin D3 plays an important role in bone metabolism and may also have immunomodulatory effects. This study was designed to estimate the prevalence of vitamin D3 deficiency in patients with rheumatoid arthritis as compared to healthy controls and to analyze the association between vitamin D3 with disease activity.
Methods: This case-control study included 50 consecutive rheumatoid arthritis patients, who fulfilled EULAR-ACR-2010 and ACR 1987 criteria for Rheumatoid Arthritis, and 50 age matched controls. Their mean age and standard deviation (SD) was 46.42±10.86 years. They were not on vitamin D3 supplements. They were selected from the Rheumatology and Medical Rehabilitation Department of Rizgary Teaching Hospital in Erbil City. The activity of disease was assessed by disease activity score and clinical disease activity index parameters. The vitamin D3 was measured for all patients and controls.
Results: A total of 100 participants were enrolled in the study. The vast majority of them were female, and 70% of cases had deficient vitamin D3 levels, while 46% of control group suffered from vitamin D3 deficiency (P <0.05). There was a non-significant statistical relationship between vitamin D3 levels and duration of disease, disease activity score and clinical disease activity index.
Conclusion: Level of vitamin D3 was low among cases compared to controls and it was statistically significant. Vitamin D3 was not correlated with the disease activity.
Kostoglou-Athanassiou I, Athanassiou P, Lyraki A, Raftakis I, Antoniadis I. Vitamin D and rheumatoid arthritis.Ther Adv Endocrinol Metab 2012; 3(6).
Shah A. Harrison's Principle of Internal Medicine. 18th ed. United States: McGraw Hill; 2012.P. 2738.
Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet 2010; 376 (9746): 1094–108.
Mason R, Sequeira V, GordonThomson C. Vitami D: The light side of sunshine. Eur J Clin Nutr. 2011Sep;65(9):986-93.
British Society for Rheumatology Biologics Register (BSRBR). Clinical aspects of vitamin D in the management of rheumatoid arthritis .2008 ;36(8):442-6.
Jankosky C, Deussing E, Gibson R, Haverkos H. Viruses and vitamin D in the etiology of type 1 diabetes mellitus and multiple sclerosis. Virus Res 2012; 163.
Tetlow LC, Smith SJ, Mawer EB, Woolley DE. Vitamin D receptors in the rheuamatoid lesion: expression by chondrocytes, macrophages and synoviocytes.Ann Rheum Dis 1999;58.
Song GG, Bae SC, Lee YH. Association between vitamin D intake and the risk of rheumatoid arthritis: a meta-analysis. Clin Rheumatol 2012; 31.
Kim TH, Choi SJ, Lee YH, Song GG, Ji JD. Combinedtherapeutic application of mTOR inhibitor and vitaminD(3) for inflammatory bone destruction of rheumatoidarthritis. Med Hypotheses 2012; 79.
Sharma R, Saigal R, Goyal L, Mital P, Yadav RN, Meena PD, et al. Estimation of vitamin D levels in rheumatoid arthritis patients and its correlation with the disease activity. JAPI 2014; 62.
Pearce SH, Cheetham TD; Diagnosis and management of vitamin D deficiency. BMJ. 2010;340
Shuler FD, Wingate MK, Moore GH, Giangarra C. Sports health benefits of vitamin D. Sports Health 2012; 4.
Landewe RB, Boers M, Verhoeven AC, Westhovens R, van de Laar MA, Markusse HM, et al. COBRA combination therapy in patients with early rheumatoid arthritis: long-term structural benefits of a brief intervention. Arthritis Rheum 2002; 46.
O'Dell JR, Leff R, Paulsen G, Haire C, Mallek J, Eckhoff PJ, et al. Treatment of rheumatoid arthritis with methotrexate and hydroxychloroquine, methotrexate and sulfasalazine, or a combination of the three medications: results of a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum 2002; 46.
Cantorna MT, Hayes CE, DeLuca HF. 1,25-Dihydroxyvitamin D3 reversibly blocks the progression of relapsing encephalomyelitis, a model of multiple sclerosis. ProcNatlAcadSci USA 1996; 93.
Kamen DL, Cooper GS, Bouali H, Shaftman SR, Hollis BW, Gilkeson GS. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev2006; 5.
Sahebarim M, Mirfeizi Z, Rezaieyazdi Z, Rafatpanah H, Goshyeshi L. 25(OH) vitamin D serum values and rheumatoid arthritis disease activity (DAS28 ESR).Caspian Journal of Internal Medicin2014;5(3).
Yassin A, Gareeb NA, Samy C. The rehabilitation between vitamin D and disease activity in Egyptian patients with Rheumatoid Arthritis .international trends of immunity2014;3
Wang Y, Zhang F, Wang S, Serum Vitamin D is inversely Associated with Anti-cyclic Citrullinated Peptid Antibody level disease activity in Rheumatoid Arthritis Patients. Arch Rheumatoid2016;31.
Allam NT, EL-Waked MM, El-Abed DM, Dorgham DA, Prevalence of Vitamin D difficiency in Egyptian Rheumatoid Arthritis Patients: Correlation with disease activity, functional disability, and bone mineral density .Egypt Rheumatol Rehabil2014;41.
Craig SM, Yu F, Curtis JR, Alarcón GS, Conn DL, Jonas B, et al. Vitamin D status and its associations with disease activity and severity in African Americans with recent onset rheumatoid arthritis. J Rheumatol 2010; 37(2).
Cutolo M, Otsa K, Laas K, Yprus M, Lehtme R, Secchi ME, et al. Circannual vitamin d serum levels and disease activity in rheumatoid arthritis: Northern versus Southern Europe. ClinExpRheumatol. 2006; 24(6).
Borges MC, Martini LA, Rogero MM. Current perspectives on vitamin D, immune system, and chronic diseases. Nutrition 2011; 27(4).
Gopinath K, Danda D. Supplementation of 1,25dihydroxy vitamin D3 in patients with treatment naive early rheumatoid arthritis: a randomised controlled trial. Int J Rheum Dis 2011;14(4).
Cutolo M, Otsa K, Laas KM, Lehtme R, Secchi M, Sullli A, et al. Circulating vitamin D serum levels and disease activity in rheumatoid arthritis: Northern versus Southern Europe. ClinExpRheumatol 2006; 24(6).
Rossini M, MaddaliBongi S, La Montagna G, Minisola G, Malavolta N, Bernini L, et al. Vitamin D deficiency in rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability. Arthritis Res Ther 2010; 12(6).
Sharma R, Saigal R, Goyal L, Mital P, Yadav R, Meena P, et al. Estimation of Vitamin D Levels in Rheumatoid Arthritis Patients and its correlation with the Disease Activity.journal of the association of physician of INDIA2014;62.
Jones G, Strugnell SA, DeLuca HF. Current understanding of the molecular actions of vitamin D. Physiol Rev 1998; 78.
Manolagas SC, Werntz DA, Tsoukas CD, Provvedini DM, Vaughan JH. 1, 25-dihydroxyvitamin D3 receptors in lymphocytes from patients with rheumatoid arthritis. J Lab Clin Med 1986; 108.
Cherniack EP. A Ray of Hope for Tender Joints: Vitamin D and Rheumatoid Arthritis. J Rheumatol 2011; 38.
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