25-hydroxy vitamin D and its relationship with clinical and laboratory parameters in patients with rheumatoid arthritis.
Clin Rheumatol. 2014 Jun 13. [Epub ahead of print]
Abourazzak FE1, Talbi S, Aradoini N, Berrada K, Keita S, Hazry T.
1Rheumatology Department, Hassan II University Hospital, Fez, Morocco, f.abourazzak at yahoo.fr.
The objective of this study is to evaluate the prevalence of vitamin D insufficiency in patients with rheumatoid arthritis (RA) and its association with disease activity, severity and physical disability. We included patients with rheumatoid arthritis followed in Rheumatology Department of Hassan II University Hospital, Fez, Morocco. Patients suffering from liver and kidney insufficiency and those who had received vitamin D in the previous 12 months have been excluded. Statistical analysis was done using SPSS v 18. A bivariate analysis and logistic regression were used to identify factors associated with vitamin D deficiency. One hundred seventy patients were included with a mean age of 50 ± 12.1 [17-83] years, and a female predominance (88.1 %).
All of our patients had hypovitaminosis D.
The prevalence of 25(OH)-D insufficiency and deficiency was 64.5 and 35.5 % successively.
In unadjusted analysis, vitamin D concentration was inversely associated with
(pain visual analog scale VAS score (p < 0.001),
- asthenia VAS (p < 0.001),
- morning stiffness (p = 0.03),
- number of tender joints (p = 0.004),
- number of swollen joints (p < 0.001),
- inflammatory markers (p = 0,012),
- Disease Activity Score (p = 0.009),
- physical disability using Health Assessment Questionnaire (HAQ) (p = 0.001), and
- severity of the disease (p < 0.001).
After logistic regression persisted association with female sex (OR = 4.3, CI = [0.94 to 20.976], p = 0.05), asthenia VAS (OR = 1.029, CI = [1.011 to 1.046], p = 0.001), and with the severity of the disease (OR = 2.910, CI = [1.314-6.441], p = 0.008). The vitamin D deficiency is common in our patients with RA. This deficiency is associated with female sex, severe asthenia, and the severity of the disease.
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- High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015
- Active Rheumatologic disease was 5X more likely with low vitamin D – June 2013
- 100 percent of rheumatoid arthritis patients with very low vitamin D had very severe RA – Jan 2013
- Overview Rheumatoid Arthritis and vitamin D which has the following quote from several years ago
From my perspective, it is now virtually criminal negligent malpractice to treat a person with RA and not aggressively monitor their vitamin D levels to confirm that they are in a therapeutic range of 50-70 ng/ml.
- Hypovitaminosis D in recent onset rheumatoid arthritis is predictive of reduced response to treatment and increased disease activity: a 12 month follow-up study March 2015
'In patients with early RA and basal hypovitaminosis D after 12 months follow-up reduction of disease activity and percentage of remission and response to treatment were significantly lower than those observed in patients with normal vitamin D levels. '