scholarly journals Association between vitamin D and fatigue in patients with rheumatoid arthritis: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034935
Author(s):  
Lars Petter Jelsness-Jørgensen ◽  
Lars Grøvle ◽  
Anne Julsrud Haugen
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Psychological Distress ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Serum Concentrations ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Liquid Chromatography Tandem Mass

ObjectivesIn rheumatoid arthritis (RA), fatigue is an important complaint with a significant impact on quality of life. Vitamin D has modulatory effects on cells of the immune system and may potentially affect RA disease activity and thereby RA-related fatigue. The purpose of this study was to explore associations between fatigue and vitamin D status in patients with RA.DesignHypothesis-generating cross-sectional study.SettingScheduled follow-up visits at a hospital-based general rheumatology clinic.ParticipantsPatients (n=169) with established RA.Primary outcome measures and anlysesFatigue, assessed by the Chalder fatigue questionnaire, and serum concentrations of 25-hydroxyvitamin D (25(OH)D), assessed by liquid chromatography–tandem mass spectrometry. Associations were analysed by correlation, and multivariate linear regression with adjustments for age, sex, body mass index, RA disease activity as measured by the Disease Activity Score 28-joint count C reactive protein (DAS28-CRP), psychological distress, pain and sleep. Fatigue was also compared across four groups based on the levels of serum 25(OH)D with cut points at 30, 50 and 75 nmol/L using one-way analysis of variance.ResultsTwo-thirds of the patients (116/169, 69%) were classified with low RA disease activity, that is, a DAS28-CRP score below 3.2. Their mean (SD) serum 25(OH)D concentration was 56.3 (21.2) nmol/L, with 77 (45.6%) having values below 50 nmol/L and 12 patients (7.1%) below 30 nmol/L. The correlation between fatigue and serum concentrations of 25(OH)D was weak and not statistically significant, r = −0.14 (95% CI: −0.29 to 0.03, p=0.08). In the multivariate model, fatigue was significantly associated with RA disease activity, psychological distress and pain, but not with serum 25(OH)D. Fatigue did not differ across groups with varying levels of serum 25(OH)D.ConclusionThis cross-sectional study found no evidence of association between vitamin D and fatigue in patients with RA.

scholarly journals Vitamin D Deficiency Is Common in Ghana despite Abundance of Sunlight: A Multicentre Comparative Cross-Sectional Study

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Samuel Asamoah Sakyi ◽  
Maxwell Hubert Antwi ◽  
Linda Ahenkorah Fondjo ◽  
Edwin Ferguson Laing ◽  
Richard K. Dadzie Ephraim ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Geographical Area ◽  
Daily Intake ◽  
Cross Sectional Study ◽  
The Body ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Background. Vitamin D is a steroid hormone important for the normal functioning of the body. It is produced through skin exposure to sunlight and from the diet. Although Ghana is located in the tropics where sunlight is abundant, factors like culture, diet, skin pigmentation, variation in the ozone layer, and geographical area influence the optimization of vitamin D concentration. It is imperative to evaluate the interplay between sunshine exposure, proinflammatory cytokines, and mediators of vitamin D metabolism and their relationship to vitamin D status in three geographical sections among apparent healthy Ghanaians. Methods and Results. In a cross-sectional study, a total of five hundred (500) healthy blood donors from three geographical areas in Ghana were enrolled. Their age ranged from 17 to 55 years with a mean age of 27.97 ± 8.87 years. The overall prevalence rate of vitamin D deficiency was 43.6% (218/500), with 41.2% (91/221), 45.3% (63/139), and 45.7% (64/140) of vitamin D deficiency being recorded in participants from the Northern Sector (NS), Middle Belt (MB), and Southern Sector (SS), respectively. However, there were no significant differences in the proportions of vitamin D deficiency across various geographical sectors. The median 25-hydroxyvitamin D serum levels were compared among geographical areas (NS, MB, and SS) and there were no significant differences ( P = 0.275 ) after adjusting for confounding factors. 25-Hydroxyvitamin D correlated positively with corrected ionized calcium (rs = 0.622, P ≤ 0.001 ) and phosphorus (rs = 0.299, P ≤ 0.001 ) and negatively correlated with SBP (rs = −0.092, P = 0.039 ), vitamin D binding protein (VDBP) (rs = −0.421, P ≤ 0.001 ), intact parathyroid hormone (iPTH) (rs = −0.0568, rs ≤ 0.001), IFN-gamma (rs = −0.684, P ≤ 0.001 ), and TNF-alpha (rs = −0.600, P ≤ 0.001 ). After adjusting for possible confounders, not having knowledge about vitamin D foods, taking fewer vitamin D foods, and higher levels of IF-γ and IL-10 were associated with a higher risk of having vitamin D deficiency. Conclusion. The prevalence of 25-hydroxyvitamin D deficiency is high among the general adult population in Ghana despite the abundance of sunlight. Increasing knowledge on vitamin D diet coupled with a daily intake of vitamin D dietary supplements is likely to reduce the risk of developing 25-hydroxyvitamin D deficiency.

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