Cristina Vdovcenco

Moldova

Vitamin D status in Rheumatoid Arthritis

Cristina Vdovcenco1, Elena Deseatnicova1,2
1 Rheumatology and nephrology discipline, “Nicolae Testemitanu” University, Chisinau, Republic of Moldova
2 Immunology Laboratory, “Nicolae Testemitanu” University, Chisinau, Republic of Moldova

Abstract

Background

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the joints and can lead to severe disability. It has been established the direct involvement of vitamin D in various autoimmune diseases such as diabetes mellitus type 1 or multiple sclerosis. It is believed that Vitamin D deficiency plays a role in exacerbating the autoimmune process.

Methods

In this study we involved 60 patients diagnosed with rheumatoid arthritis and 60 age-and sex-matched healthy controls, we measured their levels of 25(OH) vitamin D (immunochemiluminescence test in serum). We classified as deficiency levels below 20 ng/ml, while the results under 10 ng/ml were classified as severe deficiency. Subsequently, clinical and laboratory parameters were collected in order to evaluate and conclude about the disease activity through the DAS28-CRP index.
In order to analyze the results we applied statistical

Results

Our study found a outstanding lower level of 25(OH)vit D in patients with RA 14.2±4.53 ng/ml compared to healthy individuals 28.3± 6.58, p<0.001.
All the patients were previously tested positive for rheumatoid factor and/or anti-CCP. A remarcable deficiency of 25(OH)vitaminD levels was associated with 12.8% out of the RA diagnosed patients. The study results indicate an inverse correlation between vitamin D levels and the RA activity, that is, high disease activity correlated negatively with 25(OH) vitamin D level, r=-0.62, p<0.001. The severity of vitamin D deficiency associated positively with anti-CCP level, r=0.38, p<0.05. The average value in DAS28-CRP was 4.8±0.36

Conclusions

? A complicated interaction between VitD and the evolution of RA has been identified.
? 60% of the RA diagnosed patients in our study had were reported with 25(OH)vit D deficiency wich correlated negatively with disease activity and positively with serum anti- CCP level.
? VitD deficiency detection and supplementation is recommended in patients diagnosed with RA