Rheumatoid Arthritis score extrapolates to zero at 51 ng of Vitamin D (India)
ASSESSMENT OF VITAMIN D LEVELS AND ITS BIOCHEMICAL MARKERS IN PATIENTS WITH RHEUMATOID ARTHRITIS: A CASE-CONTROL STUDY
Int J Med Pub Health 2024; 14 (2); 741-745 DOI: 10.5530/ijmedph.2024.2.142
P. Yasodamma1, Appari Kanaka Maha Lakshmi2, Bharathi Gangumalla3, Ganedi Seshu Kumari4
Background: Rheumatoid arthritis (RA) is a chronic inflammatory disorder primarily affecting joints, with systemic implications. Vitamin D, beyond its role in calcium homeostasis and bone health, has immunomodulatory properties. Emerging evidence suggests a link between vitamin D deficiency and RA severity.
Objectives: This study aims to:
i) Assess serum 25- hydroxyvitamin D levels in RA patients compared to healthy controls
ii)Analyze biochemical markers associated with vitamin D metabolism in both groups.
iii)Investigate the correlation between vitamin D levels and RA disease severity.
Material and Methods: A case-control study was conducted over 12 months at an outpatient clinic affiliated with Rangaraya Medical College, Kakinada. The study included 100 participants: 50 RA patients diagnosed per American College of Rheumatology criteria and 50 age- and sex-matched healthy controls. Exclusion criteria included other autoimmune diseases, chronic inflammatory conditions, and current vitamin D supplementation. Baseline demographic and clinical data were collected, along with serum levels of 25- hydroxyvitamin D, calcium, phosphate, parathyroid hormone (PTH), C- reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Statistical analyses included independent t-tests, Pearson correlation, and multivariate regression.
Results: RA patients exhibited significantly lower serum 25-hydroxyvitamin D levels (15.4 ± 5.2 ng/mL) compared to controls (28.6 ± 6.3 ng/mL, p < 0.001). They also had elevated PTH, CRP, and ESR levels, and reduced serum calcium. A significant negative correlation was found between vitamin D levels and RA disease activity (DAS28, r = -0.42, p = 0.003). Multivariate regression identified RA duration, DAS28 score, serum calcium, PTH, and CRP as independent predictors of vitamin D deficiency.
Conclusion: RA patients show significant vitamin D deficiency, correlating with disease severity. Monitoring and addressing vitamin D levels may be crucial in managing RA.
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