Abstract
Objective Observational studies have shown that vitamin D levels are inversely related to rheumatoid arthritis activity, yet evidence from population interventions remains inconsistent.Methods: The PubMed, Cochrane Library, Embase, CNKI, VIP, and Wanfang databases were searched for studies published before June 2020. Information was collected about the pain visual analog scale (VAS), Disease Activity Score 28 (DAS28), serum vitamin D level, tender joint count (TJC), swollen joint count (SJC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and parathyroid hormone (PTH) research data.Results: Six studies (n = 438) were included in the meta-analysis. Vitamin D supplementation resulted in a significant improvement in the DAS28 (weighted mean difference (WMD) = −0.41, 95% CI (−0.59, −0.23), P < 0.001), ESR (WMD = −3.40, 95% CI (−6.62, −0.18), P = 0.04) and TJC (WMD = −1.44, 95% CI (−2.74, −0.14), P = 0.03) but not in other outcomes. According to the subgroup analyses, VAS and serum vitamin D were improved in the European ethnic subgroups. TJC and serum vitamin D were improved in the Asian ethnic subgroups. TJC and serum vitamin D were improved in the duration ≤ 12 w subgroups, and the VAS and DAS28 in the duration > 12 w subgroup were different from those of the control group. With a vitamin D dose ≤50,000 IU, only serum vitamin D and TJC improved, and with a vitamin D dose> 50,000 IU, the VAS and DAS28 improved.Conclusions: Compared with placebo control interventions, vitamin D supplementation seemed to be an effective intervention for patients with rheumatoid arthritis. Different doses of vitamin D and durations of intervention produce different effects.
Highlights
Rheumatoid arthritis (RA) is a chronic autoimmune disease that manifests as a chronic inflammatory response, and persistent synovitis leads to progressive deterioration and impairment of joint function [1]
The results were filtered for clinical trials and Abbreviations: CI, confidence interval; CNKI, China National Knowledge Infrastructure; PubMed, National Library of Medicine; VIP, VIP Database for Chinese Technical Periodicals; MD, mean difference; PRISMA, Preferred Reporting Items Systematic Reviews and Meta-Analyses; RR, risk ratio; RCT, randomized controlled trial; SD, standard deviation; SE, standard error; WMD, weighted mean difference; DAS28, Disease Activity Score 28; VAS, Pain Visual Analog Scale; TJC, Tender joint count; SJC, Swollen joint count; ESR, Erythrocyte sedimentation rate; CRP, C-reactive protein; PTH, Parathyroid hormone
There was a significant difference in the DAS28 between the rheumatoid arthritis patients who received vitamin D supplementation and the control group. [WMD = −0.41, 95% CI (−0.59, −0.23), P < 0.001] (Figure 3B)
Summary
Rheumatoid arthritis (RA) is a chronic autoimmune disease that manifests as a chronic inflammatory response, and persistent synovitis leads to progressive deterioration and impairment of joint function [1]. RA bone fragility is caused by systemic inflammation, circulating auto-antibodies and pro-inflammatory cytokine secretion, which together have harmful effects on Vitamin D for Rheumatoid Arthritis bone [2]. Studies have found that vitamin D has certain effects on other physiological functions and pathological conditions. Vitamin D has been widely indicated to have an effect on the immune system [7]. There is evidence that VD may be involved in rheumatoid arthritis (RA). Studies have found that VD can prevent antigen expression [8] and increase and regulate T cell activity [9]
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