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Low Vitamin D levels very strongly associated with rheumatoid arthritis – Sept 2016

Prevalence of vitamin D deficiency in rheumatoid arthritis and association with disease activity and cardiovascular risk factors: data from the COMEDRA study.

Clin Exp Rheumatol. 2016 Sep 30. [Epub ahead of print]
Cecchetti S1, Tatar Z1, Galan P2, Pereira B3, Lambert C3, Mouterde G4, Sutton A5, Soubrier M6, Dougados M7.

1Department of Rheumatology, Clermont-Ferrand University Hospital, France.
2Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U1153), Bobigny, France.
3Biostatistics Department, Clermont-Ferrand University Hospital, France.
4Department of Rheumatology, Lapeyronie Hospital, Montpellier 1 University, EA2415, Montpellier, France.
5Biochemistry Department, Jean Verdier Hospital, APHP, Bondy; Paris 13 University, Sorbonne Paris Cité, Laboratory for Vascular Translational Science, INSERM (U1148), Bobigny, France.
6Department of Rheumatology, Clermont-Ferrand University Hospital, France. msoubrier at chu-clermontferrand.fr.
7Paris Descartes University, Department of Rheumatology, Hôpital Cochin, Assistance Publique, Hôpitaux de Paris, INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.

The relationship between vitamin D and rheumatoid arthritis (RA) activity remains controversial. RA is a cardiovascular risk factor. A low level of vitamin D may increase blood pressure (BP) and decrease HDL-cholesterol.
We aimed to determine the prevalence of vitamin D deficiency in RA patients compared to controls, and also to investigate the relationship between vitamin D and RA activity, and between vitamin D and cardiovascular risk factors.
Patients in the COMEDRA study with established inactive RA (1987 ACR criteria) were matched with subjects from the NUTRINET-SANTE cohort (age, gender, latitude, sampling season). Vitamin D deficiency was defined as <10 ng/mL, and insufficiency as 10 to 29.9 ng/mL.
Eight hundred and ninety-four RA patients were analysed, of which 861 were matched with controls. The prevalence of vitamin D insufficiency and deficiency was lower in RA patients than in controls: 480 (55.8%) vs. 508 (59%) and 31 (3.6%) vs. 45 (5.23%), respectively; p=0.04. There was an inverse correlation between vitamin D levels and RA activity assessed by DAS28-CRP (p=0.01), SDAI (p<0.001) and CDAI (p=0.001), but not DAS28-ESR after adjustment for age, gender, inclusion season, body mass index (BMI), vitamin D supplementation, disease duration, RF or anti-CCP status and RA treatments. Vitamin D levels were inversely correlated with BMI (p<0.001), but not with BP, total cholesterol, LDL-cholesterol, HDL-cholesterol or blood glucose.
This study demonstrates that vitamin D is inversely correlated with RA activity and BMI, but not with other cardiovascular risk factors.

PMID: 27749232

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