Vitamin D Status, Disease Activity, and Endothelial Dysfunction in Early Rheumatoid Arthritis Patients.

Alexandru Caraba,Ioana Mozoş,Marius Murariu,Viorica Crişan,Ioan Romoşan

doi:10.1155/2017/5241012

Abstract

Cardiovascular diseases represent important complications in rheumatoid arthritis (RA) patients, generated by an accelerated atherosclerosis. The aim of this study is represented by the assessment of the correlations between serum levels of vitamin D, disease activity, and endothelial dysfunction in patients with early RA. Material and Methods. The study was performed on a group of 35 patients with early RA and 35 healthy subjects matched for age and gender, as controls. In all studied subjects, the following were determined: inflammatory markers, insulin resistance, vitamin D levels, and endothelial dysfunction. Statistical analysis were performed using the Student's t-test and the Pearson's test. p values of less than 0.05 were considered statistically significant. Results. The group of patients with RA patients presented inflammation, low levels of vitamin D, elevated insulin resistance, and reduced flow-mediated vasodilation, statistically significant compared to the control group (p < 0.00001). Significant inverse correlations between the levels of 25(OH) vitamin D and DAS28, respective insulin resistance, and significant positive correlation between 25(OH) vitamin D and endothelial function were demonstrated. Conclusion. In early RA patients with moderate and high disease activity, low serum levels of vitamin D were associated with disease activity, increased insulin resistance, and endothelial dysfunction.

Highlights

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder, which typically involves smalland medium-sized joints
Lin et al showed in their meta-analysis that the RA patients exhibit lower vitamin D levels than healthy controls, and, on the other hand, these levels present an inverse correlation with the disease activity [6]
It can be observed that all RA patients presented inflammation, low levels of vitamin D, elevated insulin resistance, and reduced flow-mediated vasodilation

Summary

Introduction

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder, which typically involves smalland medium-sized joints. Rheumatoid synovitis generates cartilage breakdown, bony erosions, and loss of function of the involved joints [1]. Cardiovascular disease generated by accelerated, premature atherosclerosis represents a serious complication of RA. It is known that in RA patients, cardiovascular disease represents the cause of 40–50% of the deaths in this group of population [2, 3]. Lin et al showed in their meta-analysis that the RA patients exhibit lower vitamin D levels than healthy controls, and, on the other hand, these levels present an inverse correlation with the disease activity [6]. Antiangiogenic, and antioxidant properties, vitamin D offers protective effects on the cardiovascular system [11, 12]

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Conclusion