Abstract
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.
Highlights
Цель настоящего исследования – выявить частоту встречаемости дефицита и недостаточности витамина D у пациентов с ревматоидный артрит (РА), установить ассоциации плазменной концентрации 25(ОН)D с показателями активности заболевания
Hypovitaminosis D in recent onset rheumatoid arthritis is predictive of reduced response to treatment and increased disease activity: a 12 month follow-up study / M
Information about the authorsFirst City Clinical Hospital (64, Nezavisimosti Ave., 220013, Minsk, Republic of Belarus)
Summary
Статистический анализ полученных данных проводился с использованием программы Sta tistica 10 для Windows. Средний возраст начала заболевания пациентов обследованной выборки составил 49,7 ± 16,4 года (51,3 ± 14,0 лет для мужчин и 49,0 ± 16,2 года для женщин). Анализ проводимой терапии РА в обследованной выборке показал, что 132 пациента (84,6 %) получали базисные противовоспалительные препараты. Средний уровень 25(ОН)D у пациентов, принимавших препараты витамина D, составил 29,1 ± 10,7 нг/мл, у тех, кто не принимал – 21,4 ± 12,5 нг/мл (p = 0,002). Количество пациентов с нормальным уровнем витамина D, недостаточностью и дефицитом составило 26 (42,6 %), 21 (34,4 %) и 14 (23 %) среди принимавших препараты витамина D, среди тех, кто не принимал – 26 (27,3 %), 20 (21,2 %) и 49 (51,5 %) соответственно. Сравнительный анализ демографических данных и показателей активности РА у пациентов с разным уровнем витамина D с применением дисперсионного анализа ANOVA представлен в табл. Соотношение между уровнем витамина D, демографическими показателями и характеристиками заболевания у пациентов с РА
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