scholarly journals Impact of season on the association between vitamin D levels at diagnosis and one-year remission in early Rheumatoid Arthritis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
M. Herly ◽  
K. Stengaard-Pedersen ◽  
P. Vestergaard ◽  
R. Christensen ◽  
S. Möller ◽  
...  
2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1397-1397
Author(s):  
M. Herly ◽  
K. Stengaard-Pedersen ◽  
P. Vestergaard ◽  
R. Christensen ◽  
S. Möller ◽  
...  

Background:Low vitamin D levels are common in Rheumatoid Arthritis (RA)1, and possibly associated with disease course,2but data on vitamin D levels during long-term disease course has not been reported previously.Objectives:To describe vitamin D trajectories from time of diagnosis through 10 years follow-up in early diagnosed RA patients.Methods:The CIMESTRA trial included 160 newly diagnosed RA-patients, treated aiming at remission with methotrexate and intraarticular steroid, further randomized to ciclosporine or placebo. Vitamin D supplementation was recommended according to national guidelines. Vitamin Dtotalwas measured at diagnosis, and year 1, 5 and 10 using LC-MS/MS. 1,25(OH)2D was measured at diagnosis and year 1 using RIA. Linear mixed effects models were used to study vitamin D levels serially. We had fixed effects for time, and patients modelled as a random effect. We tested the hypothesis that percentage of patients achieving Dtotal≥ 50 nmol/l during follow-up was 90%. Analyses of associations between Dtotaland DAS28-CRP during the disease-course were adjusted for age, sex, symptom-duration prior to diagnosis and season of diagnosis.Results:Median Dtotalat baseline was 53 nmol/l (IQR 36-567.8). Dtotalincreased significantly during follow-up, independently of level at diagnosis (p<0.001). Individuals achieving Dtotal≥50nmol/l during follow-up was 80-87%, but not as high as 90% at year 1 and 5, p<0.002. DAS28-CRP during disease-course was inversely associated with Dtotaltrajectories only in crude (β-coefficient (β) -0.0034, 95%CI (-0.007; -0.0002) p=0.039) and partially adjusted analyses (β -0.003, 95%CI (-0.007; -0.002) p=0.04). Estimate was left insignificant in fully adjusted analyses (β -0.003, 95%CI (-0.0006; 0.0001) p=0.06). 1,25(OH)2D levels did not change significantly during follow-up (p=1.00).Conclusion:Dtotalincreased significantly during follow-up, but fewer than 90% achieved the recommended 50 nmol/l at year 1 and 5. Disease activity during follow-up was associated with Dtotaltrajectories only in partially adjusted analyses, while adjustment for possible confounders left estimates insignificant. Results suggest vitamin D supplementation to be recommended in all RA patients.References:Reference List[1]Herly M, Stengaard-Pedersen K, Vestergaard P, et al. The D-vitamin metabolite 1,25(OH)2 D in serum is associated with disease activity and Anti-Citrullinated Protein Antibodies in active and treatment naive, early Rheumatoid Arthritis Patients.Scand J Immunol2018;88(3):e12704. doi: 10.1111/sji.12704[2]Mouterde G, Gamon E, Rincheval N, et al. Association between Vitamin D deficiency and disease activity, disability and radiographic progression in early rheumatoid arthritis. The ESPOIR cohort.J Rheumatol2019 doi: 10.3899/jrheum.190795Disclosure of Interests:Mette Herly Grant/research support from: Pfizer Denmark - “Unrestricted Grant” for PhD projectDanish Rheumatism Association, Research Grant, Speakers bureau: Speaker for Danish Rheumatism Association, Kristian Stengaard-Pedersen: None declared, Peter Vestergaard: None declared, Robin Christensen: None declared, Sören Möller: None declared, Mikkel Ǿstergaard Grant/research support from: AbbVie, Bristol-Myers Squibb, Celgene, Merck, and Novartis, Consultant of: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Speakers bureau: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Eli Lilly, Hospira, Janssen, Merck, Novartis, Novo Nordisk, Orion, Pfizer, Regeneron, Roche, Sandoz, Sanofi, and UCB, Peter Junker: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis, Kim Hørslev-Petersen Grant/research support from: Pfizer (Travel expences), Torkell Ellingsen: None declared


Author(s):  
A. V. Rudenko ◽  
T. D. Tyabut ◽  
A. E. Buglova ◽  
G. A. Babak ◽  
P. M. Morozik ◽  
...  

Vitamin D deficiency is an important environmental risk factor that influences the prevalence and severity of several autoimmune diseases, including rheumatoid arthritis (RA). The aim of this study was to determine the incidence of vitamin D insufficiency and deficiency in patients with RA, to establish the relationship between serum vitamin D levels and indicators of disease activity. 156 patients with RA were included in the study, mean age 60.2 ± 13.9 years. Assessment of clinical status was performed, serum concentrations of rheumatoid factor (RF), C-reactive protein (CRP), total vitamin D (25(OH)D), antibodies to cyclic citrullinated peptide (ACCP) were determined. RA disease activity was evaluated using DAS28 (disease activity score), SDAI (Simplified Disease Activity Index) и CDAI (Clinical Disease Activity Index) scores. Average levels of 25(OH)D in the surveyed sample were 25.2 ± 13.2 ng/ml. The results of the study indicate a high prevalence of vitamin D deficiency in patients with RA. Normal indicators of vitamin D, its insufficiency and deficiency were observed in 47 (30.3 %), 45 (28.7 %) and 64 (40.7 %) patients, respectively. Low level of serum 25(OH)D was associated with higher indices of RA activity according to DAS28, SDAI and CDAI, as well as with greater tender joint count. Vitamin D should be prescribed as an adjunctive therapy in patients with active RA due to its potential immunomodulatory effect, as well as for the prevention and treatment of bone metabolism disorders.


2014 ◽  
Vol 28 (S1) ◽  
Author(s):  
Paula Azevedo ◽  
Andrea Batista ◽  
Antonio Baccaro ◽  
Karina Narimatsu ◽  
Pamela Modesto ◽  
...  

2020 ◽  
Vol 14 (4) ◽  
pp. 2453-2465
Author(s):  
Ramadan Yahia ◽  
Shereen M. Mohammed ◽  
Manal M. Hassanien ◽  
Shabaan H. Ahmed ◽  
Helal F. Hetta

Rheumatoid arthritis (RA) is a systemic inflammatory disease with chronic nature of joints related to autoimmunity. Vitamin D was found to modulate cell growth, function of immune cells and anti-inflammatory action. The aims of that study were to investigate serum level of vitamin D and some cytokines and to identify the correlation between vitamin D and these cytokines in RA. Totally 40 RA patients without vitamin D supplement were involved in this study. Serum level of vitamin D, interleukin-6 (IL-6), IL-10, IL-35, C-reactive protein (CRP) and tumor necrosis factor α (TNF-α), all of them were measure in all patients by enzyme-linked immunosorbent assay (ELISA). Patients were classified according to Vitamin D levels into two groups; RA patients with Vit. D deficiency (n=25) and RA patients with Vit. D sufficiency (n=15). IL-6 was lower significantly (P = 0.03) in RA patients with Vit. D sufficiency than RA patients with Vit. D deficiency. IL-10 and IL-35 were higher significantly (P = 0.0234, P = 0.0356 respectively) in RA patients with Vit. D sufficiency than RA patients with Vit. D deficiency. Vit. D was significantly positively correlated with both IL-10 (r = 0.4516, P = 0.0034) and IL-35 (r = 0.3424, P = 0.0329) and negatively correlated with IL-6 (r = -0.3188, P = 0.0479). Sufficient serum level of Vit. D is correlated with higher level of anti-inflammatory cytokines (IL-10 and IL-35) and lower level of IL-6. This support the immunomodulatory effect of Vit. D in RA.


2021 ◽  
Author(s):  
Hiroto Minamino ◽  
Masao Katsushima ◽  
Mie Torii ◽  
Wataru Yamamoto ◽  
Yoshihito Fujita ◽  
...  

Abstract Sarcopenia is an age-related disease with an increased risk of mortality. It is emerging that low serum vitamin D (25(OH)D) affects the sarcopenic state in general, but in rheumatoid arthritis (RA), these associations are not understood although the prevalence of vitamin D insufficiency is high in RA. We conducted a cross-sectional study of older female outpatients from our cohort (KURAMA) database. We measured skeletal muscle mass, handgrip strength, and gait-speed to diagnose severe sarcopenia. The serum 25(OH)D concentration was measured using electrochemiluminescence immunoassay. A total of 156 Patients (sarcopenia:44.9%, severe sarcopenia: 29.5%, and without sarcopenia: 25.6%) were enrolled. Classification of vitamin D status at a cutoff point of median 25(OH)D concentration revealed that low 25(OH)D status was associated with a high prevalence of severe sarcopenia and with low measured values of muscle mass, handgrip, and gait-speed. Furthermore, multiple regression analysis identified that low 25(OH)D status was associated with a high prevalence of severe sarcopenia (OR 6.00; 95% CI 1.99–18.08). In components of sarcopenia, both low physical performance and muscle mass were associated with low 25(OH) status. In conclusion, vitamin D levels are associated with severe sarcopenia and its components, and modification of vitamin D status including vitamin D supplementation may play a role in improving sarcopenia in RA.


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