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The relationship between vitamin D and disease activity and functional health status in rheumatoid arthritis

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Abstract

We aimed to establish the relationship between serum vitamin D levels and disease activity and health status in rheumatoid arthritis. Sixty-five patients with RA fulfilling ACR criteria for the classification of rheumatoid arthritis and forty healthy controls were included in this study. Disease activity was assessed according to the Disease Activity Score including 28 joint counts. C-reactive protein (CRP, mg/dl) was determined by the nephelometric method. Erythrocyte sedimentation rate (ESR, mm/h) was determined by the Westergren method. Rheumatoid factor (RF, IU/ml) was also determined by the nephelometric method, and RF > 20 IU/ml was defined as positive. 25-OH Vitamin D EIA Kit was used to measure serum 25-OH Vitamin D levels. We found that the mean of the 25-OH D vitamin levels of the patients with RA was not different than that of controls (P = 0.936). We divided patients with RA into three groups according to DAS28 as low activity group (group 1, n = 25), moderate activity group (group 2, n = 25), and high activity group (group 3, n = 15). 25-OH vitamin D levels of the patients in the high activity group (group 3) were found to be the lowest (P < 0.001), and the patients with moderate disease activity had lower levels than those in the mild group (P = 0.033). Serum 25-OH vitamin D levels were significantly negatively correlated with DAS28, CRP, and HAQ (respectively, r = −0.431, P = 0.000, r = −0.276, P = 0.026, and r = −0.267, P = 0.031). Serum vitamin D levels in patients with RA were similar those in the healthy controls, while it significantly decreases in accordance with the disease activity and decreasing functional capacity.

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References

  1. Firestein GS (2005) Etiology and pathogenesis of rheumatoid arthritis. In: Harris ED, Budd RC, Sargent JS, Sledge CB, Ruddy S (eds) Kelley’s textbook of rheumatology. Elsevier Saunders, Philadelphia, pp 996–1042

    Google Scholar 

  2. Sokka T (2005) Rheumatoid arthritis data bases in Finland. Clin Exp Rheumatol 23(Suppl 39):201–204

    Google Scholar 

  3. Arnson Y, Amital H, Shoenfeld Y (2007) Vitamin D and autoimmunity: new etiological and therapeutic considerations. Ann Rheum Dis 66:1137–1142

    Article  PubMed  CAS  Google Scholar 

  4. Cutalo M, Otsa K, Uprus M, Paolino S, Seriolo B (2007) Vitamin D in Rheumatoid arthritis. Autoimmun Rev 7:59–64

    Article  Google Scholar 

  5. Arnett FC, Edworthy SM, Bloch DA, Meshane DJ, Fries JF, Cooper NS (1988) The American Rheumatism Association 1987 criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  PubMed  CAS  Google Scholar 

  6. Van Gestel AM, Haagsma CJ, van Riel PL (1988) Validation of rheumatoid arthritis improvement criteria that include simplified joint counts. Arthritis Rheum 41:1845–1850

    Google Scholar 

  7. Hollick MF (2007) Vitamin D deficiency. N Engl J Med 357:266–281

    Article  Google Scholar 

  8. Hollick MF (2006) High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 81:353–373

    Article  Google Scholar 

  9. Cantorna MT, Zhu Y, Froicu M, Wittke A (2004) Vitamin D status, 1, 25-dihydroxyvitamin D3, and the immune system. Am J Clin Nutr 80:1717–1720

    Google Scholar 

  10. Harel M, Shoenfeld Y (2006) Predicting and preventing autoimmunity, myth or reality? Ann NY Acad Sci 1069:322–345

    Article  PubMed  Google Scholar 

  11. Costenbader KH, Feskanich D, Benito-Garcia E, Holmas M, Karlson E (2007) Vitamin d intake and risks of systemic lupus erythematosus and rheumatoid arthritis in women. Ann Rheum Dis 31:446–447

    Google Scholar 

  12. Patel S, Farragher T, Berry J, Bunn D, Silman A, Symmons D (2007) Association between serum vitamin D metabolite levels and disease activity in patients with early inflammatory polyarthritis. Arthritis Rheum 56:2143–2149

    Article  PubMed  CAS  Google Scholar 

  13. Orbach H, Zandman-Goddard G, Amital H et al (2007) Novel biomarkers in autoimmune diseases; prolactin, ferritin, vitamin D, and TPA levels in autoimmune diseases. Ann NY Acad Sci 1109:385–400

    Article  PubMed  CAS  Google Scholar 

  14. Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG (2004) Vitamin D intake is inversely associated with lower risk of rheumatoid arthritis in older women: results from the Iowa women’s health study. Arthritis Rheum 50:72–77

    Article  PubMed  CAS  Google Scholar 

  15. Nielen MMJ, van Schaardenburg D, van de Stadt RJ et al (2006) Vitamin D deficiency does not increase the risk of rheumatoid arthritis. Arthritis Rheum 11:3719–3724

    Article  Google Scholar 

  16. Mouyis M, Ostor AJK, Crisp AJ, Ginawi A, Halsall DJ, Shenker N, Poole KES (2008) Hypovitaminosis D among rheumatology outpatients in clinical practice. Rheumatology 47:1348–1351

    Article  PubMed  CAS  Google Scholar 

  17. Leventis P, Patel S (2008) Clinical aspects of vitamin D in the management of rheumatoid arthritis. Rheumatology 47:1617–1621

    Article  PubMed  CAS  Google Scholar 

  18. Likuni N, Nakajima A, Inoue E et al (2007) What’s in season for rheumatoid arthritis patients? Seasonal fluctuations in disease activity. Rheumatology 46:846–848

    Article  Google Scholar 

  19. Oelzner P, Miller A, Deschner F et al (1998) Relationship between disease activity and serum levels of vitamin D metabolites and PTH in rheumatoid arthritis. Calcif Tissue Int 62:193–198

    Article  PubMed  CAS  Google Scholar 

  20. Kroger H, Penttila IM, Alhava EM (1993) Low serum vitamin D metabolites in women with rheumatoid arthritis. Scand J Rheumatol 22:172–177

    Article  PubMed  CAS  Google Scholar 

  21. Andjelkovic Z, Vojinovic J, Pejnovic N et al (1999) Disease modifying and immunomodulatory effects of high dose 1 alpha (OH) D3 in rheumatoid arthritis patients. Clin Exp Rheumatol 17:453–456

    PubMed  CAS  Google Scholar 

  22. Szodoray P, Nakken B, Gaal J, Jonsson R, Szegedi A, Zold E, Szegedi G, Brun JG, Gesztelyi R, Zeher M, Bodolay E (2008) The complex role of vitamin D in autoimmune diseases. Scand J Immunol 68:261–269

    Article  PubMed  CAS  Google Scholar 

  23. Mahon BD, Gordon SA, Cruz J, Cosman F, Cantorna MT (2003) Cytokine profile in patients with multiple sclerosis following vitamin D supplementation. J Neuroimmunol 134:128–132

    Article  PubMed  CAS  Google Scholar 

  24. Cantorna MT, Hayhes CE, DeLuca HF (1998) 1, 25-Dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis. J Nutr 128:68–72

    PubMed  CAS  Google Scholar 

  25. Tetlow LC, Wolley DE (1999) The effects of 1 alpha, 25-dihydroxyvitamin D (3) on matrix metalloproteinase and prostaglandin E (2) production by cells of the rheumatoid lesion. Arthritis Res 1:63–70

    Article  PubMed  CAS  Google Scholar 

  26. Nielen NM, van Schaardenburg D, Lems W et al (2006) Vitamin D deficiency does not increase the risk of rheumatoid arthritis; comment on the article by Merlino et al. Arthritis Rheum 54:3719–3722

    Article  PubMed  Google Scholar 

  27. Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B (2006) Estimation of optimal serum concentrations of 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr 84:18–28

    PubMed  CAS  Google Scholar 

  28. Jones BJ, Twomey PJ (2008) Issues with vitamin D in routine clinical practice. Rheumatology 47:1267–1268

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Mustafa Kemal University Hospital, 31100, Hatay, Turkey

    Ayşe Dicle Turhanoğlu, Hayal Güler, Zafer Yönden, Fatma Aslan, Ayhan Mansuroglu & Cahit Ozer

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  1. Ayşe Dicle Turhanoğlu
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  2. Hayal Güler
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  3. Zafer Yönden
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Correspondence to Ayşe Dicle Turhanoğlu.

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Turhanoğlu, A.D., Güler, H., Yönden, Z. et al. The relationship between vitamin D and disease activity and functional health status in rheumatoid arthritis. Rheumatol Int 31, 911–914 (2011). https://doi.org/10.1007/s00296-010-1393-6

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