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100 percent of rheumatoid arthritis patients with very low vitamin D had very severe RA – Jan 2013

Severe deficiency of 25-hydroxyvitamin D(3) (25-OH-D (3)) is associated with high disease activity of rheumatoid arthritis.

Clin Rheumatol. 2013 Jan 15.
Haga HJ, Schmedes A, Naderi Y, Moreno AM, Peen E.
Reumaklinik Danmark, Aalborg University Esbjerg, Havnegade 19, 6700, Esbjerg, Denmark, hjh at reumaklinikdanmark.dk.

This study aims to measure the serum level of 25-hydroxyvitamin D(3) (25-OH-D(3)) in 302 patients with rheumatoid arthritis (RA), studying the association to disease activity.

Three hundred two RA patients underwent clinical examination and serological analysis. 25-Hydroxyvitamin D(3) was determined by high-performance liquid chromatography-tandem mass spectrometry. Vitamin D(3) deficiency defined as serum levels of 25-hydroxyvitamin D(3) below 50 nmol/l was detected in 101 RA patients (33.4 %).

There was no significant correlation between the serum level of 25-hydroxyvitamin D(3) and Disease Activity Score 28 (DAS28) (3w) score.

In a subpopulation of RA patients with very low serum level of 25-OH-D(3) (≤15 nmol/l) (n = 15), there were significant differences compared to patients with normal 25-OH-D(3) (n = 200):

  • higher percentage of patients with positive rheumatoid factor (100.0 versus 77.5 %; p = 0.05), *higher CRP (28.7 versus 14.8 mg/l; p = 0.001),
  • higher number of patients treated with at least three disease-modifying antirheumatic drugs (DMARDs)
    (40.0 versus 14.5 %; p = 0.02),
  • higher number of patients with high disease activity DAS28 score of ≥5.1
    (20.0 versus 4.5 %; p = 0.01),
  • lower age (54.5 versus 64.0 years; p = 0.003) and
  • shorter disease duration (5.1 versus 10.3 years; p = 0.06).

Deficiency of 25-hydroxyvitamin D(3) was detected in 33.4 % of the RA patients.
A subpopulation of patients with severe deficiency of vitamin D(3) serum level of ≤15 nmol/l was characterised by all being positive for rheumatoid factor, high percentage of patients with very high disease activity and high percentage of patients treated with at least three DMARDs.

PMID: 23318705

See also VitaminDWiki