Vitamin D status in rheumatoid arthritis patients: relation to clinical manifestations, disease activity, quality of life and fibromyalgia syndrome
International Journal of Rheumatic Diseases, DOI: 10.1111/1756-185X.12426
Tamer A. Gheita1,*, Safaa Sayed1, Heba A. Gheita2 andSanaa A. Kenawy3
1Department of Rheumatology, Faculty of Medicine, Cairo University, Cairo, Egypt
2Department of Pharmacology, Atomic Energy Authorization, Cairo, Egypt
3Department of Pharmacology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
* Correspondence: Tamer A. Gheita, MD, Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt. Email: gheitamer at hotmail.com
Average age 42 (total of 125 patients)
33 ng: No RA or FMS = Controls
27 ng: RA without FMS
19 ng: RA with FMS
No indication of levels if FMS without RA
To assess vitamin D levels in rheumatoid arthritis (RA) patients and to find their relation to clinical parameters, fibromyalgia syndrome (FMS), quality of life (QoL) and disease activity.
The study included 63 RA patients and 62 controls. Clinical examination and laboratory investigations were performed. For patients, the Disease Activity Score (DAS-28), QoL index, Health Assessment Questionnaire II (HAQ II) and Modified Larsen score were calculated. 25-OH-vitamin D was measured in patients and controls.
The patients’ mean age was 41.59 ± 9.69 years and disease duration 5.89 ± 3.67 years. The level of vitamin D in RA patients was significantly lower (23.11 ± 12.71 ng/mL) than that in the controls (32.59 ± 13.06 ng/mL) (P = 0.005) being deficient in 50.8%, insufficient in 23.8% and normal in 25.4%. The RA patients with FMS (n = 33) had significantly lower levels of vitamin D (19.08 ± 10.59 ng/mL) than those without (27.55 ± 13.51 ng/mL) (P = 0.008). The difference was significant on comparing those receiving hydroxychloroquine (17.39 ± 7.84 ng/mL) to those not (31.85 ± 13.85 ng/mL) (P < 0.001). Vitamin D significantly correlated with QoL index (r = 0.58, P < 0.001) and negatively with HAQ II (r = −0.36, P = 0.004) and BMI (r = −0.39, P = 0.001).
Special attention is required regarding vitamin D levels in RA patients with FMS and decreased QoL. Vitamin D should be corrected and supplementation considered among the RA management armamentarium.
- Overview Rheumatoid Arthritis and vitamin D
- Vitamin D and rheumatic diseases. – Review July 2014
- 100 percent of rheumatoid arthritis patients with very low vitamin D had very severe RA – Jan 2013
- Overview Fibromyalgia or Chronic Fatigue and vitamin D which has the chart showing the huge overlap between FMS and other health problems
Pages listed in BOTH the categories Pain and RA
- Rheumatoid Arthritis pain reduced by monthly 100,000 IU of Vitamin D – Oct 2018
- Widespread pain, arthritis pain and muscle pain are associated with low vitamin D – meta-analysis March 2018
- High dose vitamin reduced pain of fibromyalgia, osteoarthritis, and rheumatoid arthritis - July 2015
- Increased D levels responsible for Dead Sea therapy – May 2011