scholarly journals AB0689 THE IMPORTANCE OF THE SUN. VITAMIN D AND SPONDYLOARTHRITIS: OUR EXPERIENCE IN A THIRD LEVEL HOSPITAL.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1640.2-1640
Author(s):  
I. González Fernández ◽  
C. Álvarez Castro ◽  
C. Moriano ◽  
A. López Robles ◽  
X. E. Larco Rojas ◽  
...  
Keyword(s):  
New York ◽  
Vitamin D ◽  
Disease Activity ◽  
Intestinal Inflammation ◽  
Reference Value ◽  
Hypovitaminosis D ◽  
Lower Severity ◽  
Inflammatory Bowel ◽  
Former Smokers ◽  
Low Levels

Background:Vitamin D plays an important role in the pathogenesis of autoimmune diseases, so that it has been shown that an adequate level is associated with a lower risk of developing this group of entities as well as a lower severity of them. Specifically, in spondyloarthritis (SpA) the deficiency has been associated with greater aggressiveness and greater radiological progression.Objectives:Assess levels of vitamin D in patients diagnosed with SpA in the León University Assistance Complex and study its possible relationship with different clinical-epidemiological variables.Methods:Prospective observational study between January 1, 2019 and December 31, 2019 with consecutive sampling of patients diagnosed with SpA (New York criteria, ASAS) in our hospital between 1973 and 2018. It was taken as a cut-off point for vitamin normality D those values ≥ 30 ng / ml. The disease activity was assessed based on BASDAI and CRP level (taking as a cut-off point 5 mg/l, reference value of our hospital and ruling out elevation due to intercurrent processes) in the last consultation. Positive values above 130 mlg/dL were considered for the orosomucoid and for calprotectin as undetermined values between 50-100 mg/kg feces and suspected IBD greater than 100 mg/kg feces. An attempt was made to link the value of vitamin D with disease activity, tobacco, the development of uveitis and the presence of subclinical intestinal inflammation.Results:132 patients were included, of which 60.6% were men with a mean age of 49.35 ± 12.95 years. 84.8% were B27 positive. 88.6% met New York criteria. 35.6% suffered uveitis at some time during their evolution. As for tobacco, 68.2% were non-smokers, 12.9% were former smokers and 18.9% were active smokers. 6.8% of the sample presented positivity for the orosomucoid and 37.8% alterations in calprotectin (of which 24.2% were undetermined and 13.6% suspected of inflammatory bowel disease). Only 25% of patients had elevated CRP levels and 11.4% of patients had BASDAI> 4. 50.8% of our sample had optimal levels of Vitamin D while 49.2% were at low values.A statistically significant association was observed between hypovitaminosis D and elevated CRP levels (p 0.038). In our sample we found no statistical association with uveitis or with markers of subclinical inflammatory activity.Conclusion:-Almost half of the patients in our sample have hypovitaminosis D which is probably attributable to the meteorological characteristics of León region.-Low levels of vitamin D are statistically significantly related to higher levels of CRP and, therefore, with greater disease activity.-No significant relationship was found with uveitis or with a higher risk of subclinical intestinal inflammation in our simple.References:[1]Castro Domínguez F, Salman Monte TC, Blanch Rubió J. Vitamin D in rheumatic diseases.Rev Osteoporos Metab Miner. 2017; 9 (1) supplement: 31-39.Disclosure of Interests:None declared

scholarly journals The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2583 ◽  
Author(s):  
Maria Chiara Mentella ◽  
Franco Scaldaferri ◽  
Marco Pizzoferrato ◽  
Antonio Gasbarrini ◽  
Giacinto Abele Donato Miggiano
Keyword(s):  
Vitamin D ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Phase Angle ◽  
Alimentary Tract ◽  
Hypovitaminosis D ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Inflammatory Bowel

Hypovitaminosis D is frequently present in inflammatory bowel disease (IBD) with a higher incidence in Crohn’s disease (CD) than in Ulcerative Colitis (UC). Given the involvement of the alimentary tract, many factors can contribute to hypovitaminosis D. The aim of the study was to investigate the association of disease activity, body mass index (BMI) and phase angle with vitamin D deficiency in patients with IBD. A cross-sectional study was conducted on a cohort of 206 IBD patients (October 2016–September 2018). Of these patients, 32.6% were affected by hypovitaminosis D (CD: 38.6%; UC: 25.6%; p < 0.01). Negative and significant associations (p < 0.01) were found between BMI and vitamin D serum levels both in CD and UC patients. BMI represented a determinant of hypovitaminosis D (Odds Ratio (OR) = 1.12, p < 0.01) only in UC patients; phase angle was associated to hypovitaminosis D in both groups (CD: OR = 0.64, p < 0.05; UC: OR = 0.49, p < 0.01). Results of the present study confirm a higher incidence of hypovitaminosis D in patients with CD than in those with UC, and show that nutritional status plays a crucial role in the incidence of vitamin D deficiency in patients with IBD.

scholarly journals AB0806 DOES VITAMIN D INFLUENCE THE ACTIVITY OF THE DISEASE IN PATIENTS WITH PSORIATIC ARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1704.1-1705
Author(s):  
L. Montolio-Chiva ◽  
A. V. Orenes Vera ◽  
M. Aguilar-Zamora ◽  
C. Vergara-Dangond ◽  
I. Vázquez-Gómez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Functional Capacity ◽  
Inverse Correlation ◽  
Hypovitaminosis D ◽  
Joint Involvement ◽  
Average Value ◽  
Vitamin D Levels

Background:Several studies have shown an inverse relationship between vitamin D levels (25OHD) and disease activity in patients with rheumatoid arthritis (RA). However, the existing data in patients with psoriatic arthritis (PsA) are poor, and they use the DAS28 index as a peripheral joint activity marker by extrapolation with RA.Objectives:To analyze the relationship between 25OHD levels, disease activity and functional capacity in patients with PsA.Methods:Transversal, observational, descriptive study. We included PsA patients with peripheral joint involvement. We collected demographic variables (gender, age), clinical variables [follow-up, received treatments, TJC (68), SJC (68), VAS] and analytical variables (25OHD, CRP, ESR). We usedDisease activity in psoriatic arthritis(DAPSA) score to measure disease activity, and theHealth assessment questionnaire(HAQ) to determine functional capacity. Levels of 25 OHD <20 ng/ml and between 20-30 ng/ml were considered deficient and insufficient, respectively. Statistical analysis was made with SPSS 22.0. The descriptive analysis results were expressed as percentage and mean ± SD. We used Pearson’s correlation to assess the association between quantitative variables and T test to compare means between dichotomous variables.Results:125 patients were included, the majority women (60.8%), with an average age of 55.4 (SD 12.2) years. The average follow-up was 75.5 (SD 68.3) months. 97.6% of patients had received DMARDs and 40.8% biologics, and almost half of the patients (42.7%) took calcium and 25OHD supplements. The average value of 25OHD was 27.1 (SD 12.1) ng/ml, with 30% of patients having 25OHD deficit and 63.3% insufficiency. The majority of patients had an acceptable disease control, with a mean DAPSA of 10.5 (SD 7,9); and mean of CRP, ESR, TJC and SJC was 6.1 (SD 3.7) mg/l, 10.2 (SD 9.9) mm/h, 1.3 (SD 2.5) and 0.7 (SD 2.1), respectively. The average value of HAQ was 0.6 (SD 0.7). We observed an inverse correlation between 25OHD levels and joint counts, TJC (p=0.02) and SJC (p=0.03). On the other hand, patients with hypovitaminosis D presented a tendency to get higher scores in DAPSA index (P=0.07). We do not observe any relationship between 25OHD and HAQ.Conclusion:As can be seen in our sample, low values of 25OHD are related to increased disease activity in patients with PsA.Disclosure of Interests:L Montolio-Chiva: None declared, Ana V Orenes Vera: None declared, Marta Aguilar-Zamora: None declared, C Vergara-Dangond: None declared, I Vázquez-Gómez: None declared, Eduardo Flores: None declared, A Sendra-García: None declared, À Martínez-Ferrer: None declared, Elia Valls-Pascual Grant/research support from: Roche, Novartis, and AbbVie, Speakers bureau: AbbVie, Lilly, Pfizer, MSD, Novartis, Janssen, Bristol Myers Squibb, UCB Pharma, D Ybáñez-García Speakers bureau: Lilly, Roche, Sanofi, V Núñez-Monje: None declared, I Torner-Hernández: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis

Hypovitaminosis D in Patients with Ankylosing Spondylitis: Frequency and Consequences

2021 ◽  
Vol 17 ◽  
Author(s):  
Gehan Elolemy ◽  
Waleed Hassan ◽  
Mohamed Nasr ◽  
Eman Baraka
Keyword(s):  
Vitamin D ◽  
Ankylosing Spondylitis ◽  
Disease Activity ◽  
Bone Mineral ◽  
Hypovitaminosis D ◽  
Healthy Controls ◽  
Mineral Density ◽  
Z Scores ◽  
The Impact ◽  
Active Disease

Objectives: was to assess the frequency of hypovitaminosis D in patients with ankylosing spondylitis (AS) compared to healthy controls and to evaluate its association with disease activity, structural damage and bone mineral density (BMD). Methods: Serum 25(OH) D in 30 AS male patients was compared to 30 matched healthy controls. AS disease activity was assessed using AS Disease Activity Score and C - reactive protein (ASDAS-CRP). Bath AS Functional Index (BASFI) and Bath AS Metrology Index (BASMI) were used to assess the functional impairment and the spinal mobility respectively. Radiological damage was scored according to modified Stoke AS Spine Score (mSASSS) and BMD was measured in the lumbar spine and femoral neck. Results: The mean serum 25(OH)D levels in AS patients were significantly lower compared to healthy controls (27.73 ± 14.27 vs. 38.46 ± 8.11ng/ml, P <0.001). Among the patients, 60% exhibited hypovitaminosis D. AS patients with hypovitaminosis D had significantly higher ASDAS-CRP (p<0.001), BASFAI (p=0.0003) and mSASSS (p=0.04) scores. Additionally, BMD and Z scores at lumbar and femoral sites were significantly reduced in the patients with hypovitaminosis D (P < 0.05). Serum 25(OH)D was positively correlated with BMD (lumbar and femoral; p=0.002 and p=0.01 respectively) and Z scores (lumbar and femoral; p<0.001and p=0.01 respectively), whereas, negatively correlated with ASDAS-CRP (p<0.001), BASFI (p<0.001), mSASSS (p=0.003). ASDAS -CRP was the only significant predictor of hypovitaminosis D in AS patients. Conclusions: hypovitaminosis D is prevalent among AS patients and is associated with increased risk of active disease, impaired function, radiographic severity and bone mineral loss. Future studies with larger sample size are recommended to assess the impact of vitamin D deficiency on radiological progression in AS and to address whether or not vitamin D supplementation will help control active disease.

P-052 YI Vitamin D Status and Inflammatory Bowel Disease—The Role in Disease Activity and Quality of Life

2013 ◽  
Vol 19 ◽  
pp. S48
Author(s):  
Francisca Dias de Castro ◽  
Joana Magalhães ◽  
Pedro Carvalho ◽  
Maria João Moreira ◽  
Paula Mota ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Disease ◽  
Vitamin D ◽  
Disease Activity ◽  
Bowel Disease ◽  
Vitamin D Status ◽  
Inflammatory Bowel

scholarly journals Vitamin D Modulates Intestinal Microbiota in Inflammatory Bowel Diseases

2020 ◽  
Author(s):  
Carolina Battistini ◽  
Rafael Ballan ◽  
Marcos Herkenhoff ◽  
Susana Saad ◽  
Jun Sun
Keyword(s):  
Vitamin D ◽  
Gut Microbiota ◽  
Disease Activity ◽  
Chronic Inflammation ◽  
Immune Cell ◽  
Future Directions ◽  
Dihydroxyvitamin D3 ◽  
Host Interactions ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel disease (IBD) is a chronic inflammation of the gastrointestinal0 tract (GIT), including Crohn&rsquo;s disease (CD) and ulcerative colitis (UC), which differ in the location and lesion extensions. Both diseases are associated with microbiota dysbiosis, with a reduced population of butyrate-producing species, abnormal inflammatory response, and micronutrient deficiency (e. g. vitamin D hypovitaminosis). Vitamin D (VitD) is involved in immune cell differentiation, gut microbiota modulation, gene transcription, and barrier integrity. Vitamin D receptor (VDR) regulates the biological actions of the active VitD (1&alpha;, 25-dihydroxyvitamin D3), and is involved in the genetic, environmental, immune, and microbial aspects of IBD. VitD deficiency is correlated with disease activity and its administration targeting a concentration of 30 ng/mL may have the potential to reduce disease activity. Moreover, VDR regulates functions of T cells and Paneth cells and modulates release of antimicrobial peptides in gut microbiota-host interactions. Meanwhile, beneficial microbial metabolites, e.g. butyrate, upregulate the VDR signaling. In this review, we summarize the clinical progress and mechanism studies on VitD /VDR related to gut microbiota modulation in IBD. We also discuss epigenetics in IBD and the probiotic regulation of VDR. Furthermore, we discuss the existing challenges and future directions. There is a lack of well-designed clinical trials exploring the appropriate dose and the influence of gender, age, ethnicity, genetics, microbiome, and metabolic disorders in IBD subtypes. To move forward, we need well-designed therapeutic studies to examine whether enhanced vitamin D will restore functions of VDR and microbiome in inhibiting chronic inflammation.

scholarly journals Hypovitaminosis D Is Prevalent in Patients with Renal AL Amyloidosis and Associated with Non-t(11;14)

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5523-5523
Author(s):  
Eli Muchtar ◽  
Matthew T. Drake ◽  
Angela Dispenzieri ◽  
Martha Q. Lacy ◽  
Francis K. Buadi ◽  
...  
Keyword(s):  
Vitamin D ◽  
Research Funding ◽  
Renal Involvement ◽  
Hypovitaminosis D ◽  
Al Amyloidosis ◽  
Advisory Committees ◽  
Heavy Proteinuria ◽  
Vitamin D Levels ◽  
Low Levels ◽  
Low Serum

Introduction: Vitamin D deficiency is common, with 25-50% of the population having levels below the optimal range (<20 ng/mL). Aside from its role in maintaining serum calcium and skeletal homeostasis, vitamin D has been shown to play an important role in regulation of differentiation, proliferation, apoptosis, metastatic potential and angiogenesis in a variety of malignancies. Low serum 25(OH)D levels have been associated with a worse prognosis in several malignancies, including colorectal and breast cancer, chronic lymphocytic leukemia and non-Hodgkin's lymphoma. Almost no data have been reported on vitamin D levels in light chain (AL) amyloidosis. We therefore measured vitamin D levels among AL patients and correlated levels at presentation to explore if vitamin D deficiency has any effect or association in this disease. Methods: Stored serum samples from 90 patients with newly diagnosed AL amyloidosis were obtained for vitamin D studies, which included 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2D] and vitamin D binding protein (DBP). All vitamin D measurements were made by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Total 25(OH)D and 1,25(OH)2D was assessed as the additive sum of the 25(OH)D2/25(OH)D3 and 1,25(OH)2D2/1,25(OH)2D3 components, respectively. Clinical data was extracted from the electronic medical records. All calculations were made using JMP software (SAS, Cary, NC). Results: All patients were seen between June 2004 and September 2013. Median age was 63 [IQR 57-70]. Heart, kidney, nerve, liver and gastrointestinal amyloidosis was seen in 80%, 60%, 19%, 17% and 13% of patients, respectively. The median dFLC and bone marrow plasma cells were 28 (IQR 12-84) mg/dL and 10% (IQR 5-20%), respectively. The median serum 25(OH)D level was 20 ng/mL (IQR 10-29; normal >20 ng/mL), while the median serum level of 1,25(OH)2D was 23 pg/mL (IQR 14-37; normal 16-64 pg/mL for men; 16-78 pg/mL for women). 25(OH)D levels <20 ng/mL were strongly associated with renal involvement (84% renal involvement vs 42% of renal involvement for levels ≥20 ng/dL, P<0.001; Table). No other association with organ involvement was seen. Among all patients, heavy proteinuria (>5 gr/24-h) was strongly associated with low 25(OH)D, (P<0.001, Table). A weaker association was seen between 25(OH)D levels and estimated glomerular filtration rate (eGFR) (P=0.06). Seventy-eight percent of patients with 1,25(OH)2D levels below 20 pg/mL had renal involvement versus 48% in those with levels above 20 pg/mL (P=0.01). While heavy proteinuria was associated with 1,25(OH)2D (P=0.008), the association was stronger for eGFR, as no patient with an eGFR <30 ml/min/1.73 m2 had a 1,25(OH)2D level above 20 pg/mL (P<0.001). An association between vitamin D levels and low serum albumin was also seen, mainly in relation to 25(OH)D (Table). The median level of serum DBP was 58 μg/mL (IQR 36 - 120 μg/mL), significantly lower than the normal range (168-367 μg/mL). Low levels of 25(OH)D or 1,25(OH)2D were not associated with lower DBP levels. Surprisingly, patients with renal involvement had higher levels of DBP versus those without renal involvement (median 70.9 vs 48 μg/mL; P=0.03), although median levels were below normal in both groups. FISH data was available in 47 of patients (52%). Patients with 25(OH)D levels <20 ng/dL were less likely to harbor t(11;14) versus patients with 25(OH)D levels above this threshold (26% vs 64%, respectively; P=0.0095). A similar, but less significant association was seen between 1,25(OH)2D levels at a 20 pg/mL threshold and t(11;14) (35% vs 59%, P=0.09). Other associations between vitamin D and FISH abnormalities were not seen. Conclusions: Hypovitaminosis D is common among AL amyloidosis patients with renal involvement. In the general cohort, heavy proteinuria, reduced eGFR and low serum albumin were all associated with low circulating vitamin D levels. Although the majority of AL patients had low levels of DBP, urinary loss of DBP does not explain the low levels of vitamin D. Hypovitaminosis D is associated with non-t(11;14) disease, a finding which warrants further exploration. Disclosures Dispenzieri: Akcea: Consultancy; Intellia: Consultancy; Janssen: Consultancy; Pfizer: Research Funding; Takeda: Research Funding; Celgene: Research Funding; Alnylam: Research Funding. Lacy:Celgene: Research Funding. Dingli:Rigel: Consultancy; Karyopharm: Research Funding; Millenium: Consultancy; Janssen: Consultancy; alexion: Consultancy. Kapoor:Cellectar: Consultancy; Celgene: Honoraria; Sanofi: Consultancy, Research Funding; Amgen: Research Funding; Takeda: Honoraria, Research Funding; Janssen: Research Funding; Glaxo Smith Kline: Research Funding. Leung:Omeros: Research Funding; Aduro: Membership on an entity's Board of Directors or advisory committees; Prothena: Membership on an entity's Board of Directors or advisory committees; Takeda: Research Funding. Russell:Imanis: Equity Ownership. Kumar:Celgene: Consultancy, Research Funding; Janssen: Consultancy, Research Funding; Takeda: Research Funding. Gertz:Ionis/Akcea: Consultancy; Alnylam: Consultancy; Janssen: Consultancy; Celgene: Consultancy; Annexon: Consultancy; Prothena Biosciences Inc: Consultancy; Spectrum: Consultancy, Research Funding.

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