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Vitamin D status in rheumatoid arthritis and its correlation with disease activity and functional ability

OBJECTIVE:We aimed to assess vitamin D status in patients with rheumatoid arthritis (RA) and to investigateits association with indices of disease activity and functional ability. SUBJECTS AND METHODS: 51RA patients and 29 osteoarthritistis (OA) patients (non- inflammatory arthtitis control group), were consecutively enrolled from the outpatient clinics of three rheumatologic centers in Zagreb (Croatia) during a winter time. Together with CRP, ESR and RF, in sera of all patients 25-Hydroxy vitamin D3 (25(0H)D3) and intact parathyroid hormone (PTH) was determined with electrochemiluminescent immunoassay (ECLI, Roche Diagnostics). RA disease activity was assessed according to the Disease Activity Score including 28 joint counts (DAS28) and functionalability by the self-report index Health Assessment Questionnaire - Disability Index (HAQ DI). RESULTS: The median serum 25(0H)D3 did not differ significantly between RA and OA patients (P=0.9401). Vitamin D deficiency (<25 nmol/L) was found in 39, 2% while insufficiency (25-75 nmol/L) in 54, 9% RA patients. When RA patients were categorized according to DAS28 score, 25(0H)D3 concentration was lower in high disease activity group (21, 0 nmoi/L) compared to moderate activity group (31, 4 nmol/L) but the difference was not significant (P=O.ll33). Low disease activity was found in only 1 patient. No correlation was confirmed for serum 25(0H)D3 with DAS28, CRP, ESR, RF or HAQ. CONCLUSION: Results demonstrate highly common vitamin D deficiency/insufficiency both in inflammatory and non-inflammatory rheumatic diseases. Although we did not find clear association of serum vitamin D with disease activity, in our opinion prophylactic supplementation with vitamin D should be recommended for rheumatic patients.

rheumatoid arthritis ; vitamin D ; disease activity

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