Vitamin D and Rheumatic Diseases: A Review of Clinical Evidence (original) (raw)
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Vitamin D and rheumatic diseases
Reumatismo, 2014
Vitamin D has some well-known effects on calcium, phosphate and bone metabolism, but it has recently shown to have many other effects, which may potentially be relevant to patients with extra-skeletal rheumatic diseases. Such effects may be justified by: 1) the presence of the vitamin D receptors also on extra-osseous cells, such as cartilage cells, sinoviocytes, muscle cells; 2) the proven role of vitamin D in the control of the transcription of genes involved in rheumatic diseases; 3) the evidence that vitamin D has multiple endocrine effects not only on calcium homeostasis; 4) the activation of vitamin D not only in the kidneys, but also in monocyte-macrophage and lymphocytic cell lines and in some epithelial cells with additional intracrine and paracrine effects. Vitamin D deficiency has been reported in numerous metabolic, degenerative, inflammatory and autoimmune rheumatic diseases. In some cases this association was also related to the risk of developing a rheumatic disease o...
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PubMed, 2019
Background/aim: Vitamin D displays an immunologic effect which can modulate function of Th17-related cytokines and thereby prevent perpetuation of inflammation in chronic disorders like rheumatoid arthritis (RA). This review aims to conduct a literature review to provide a summary of recent studies addressing the relationship between vitamin D deficiency and RA based on epidemiological, immunological and therapeutic aspects. Methods: PubMed, Scopus and Google scholar were searched for relevant papers published between 2000-2018. Results: Low intake of vitamin D increases the risk of incident RA, and vitamin D deficiency has been shown to be inversely associated with RA activity in most of these studies. However, characteristics of RA and serum vitamin D status differ across the studies. The results of studies on the effect of supplemental vitamin D in RA vary, from no efficacy to significant improvement in disease activity, as well as quality of life. This should be attributed to variations in dosage of vitamin D, duration of treatment, baseline serum vitamin D in RA patients and characteristics of RA across diverse studies. Conclusion: Current data indicate a therapeutic potential for vitamin D in RA. However, further studies are needed to identify an optimal and effective dosage, duration of treatment and patients who will get the best benefit from the treatment.
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Abstract Background Vitamin D plays an important role in bone metabolism and regulation of the immunity system. The purpose of this study was to survey the serum level of vitamin D in patients suffering from rheumatoid arthritis and its relationship with the activity of the disease. Methods This cross-sectional retrospective study was done on 216 patients attending rheumatology clinics in Qom Province meeting the criteria of American Rheumatology Association. The activity of the disease was calculated based on the DAS28 (Disease activity score in 28 joints) using the related software. The cut-off points of DAS28 of 2.6, 3.2 and 5.1 have been suggested to be indica - tions of remission, low disease activity and high disease activity, respectively. Patients in the active disease group were further classified into four subgroups, including intensive Disease Activity Subgroup (DAS 28 exceeding 5.1), average disease activity subgroup (DAS 28 3.2-5.1), mild disease activity subgroup (DAS 28 3.2-2.6), and inactive disease subgroup (DAS 28 below 2.6). Results The results showed that the activity of rheumatoid arthritis disease was increased as serum levels of vitamin D decreased. In other words, the prevalence of vitamin D deficiency among patients suffering from severe rheumatoid arthritis activity was high. A significant difference was also observed between the serum level of vitamin D and erythrocyte sedimentation rate (ESR) , C-reactive protein (CPR), platelet count, and visual analogue scale (VAS) (P<0.001), but no significant relationship was found between serum levels of vitamin D and the number of affected joints and WBS. Conclusion There is a significant relationship between vitamin D deficiency in patients suffering from rheumatoid arthritis and the activity of the disease.
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Correlation between Vitamin D Deficiencyand Rheumatoid Arthritis Patients.
The main aim and objective of this study was to determine the prevalence of Vitamin D deficiency in patients with rheumatoid arthritis (RA) and compare the serum Vitamin D levels to healthy controls and also establish relationship between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability. A cross sectional study was designed to include 50 RA patients (case) and 50 (controls), from Rajiv Gandhi Hospital & Research Center from duration 2012-2015. All patients had serum 25(OH) D measured in a laboratory and Vitamin D levels were analyzed in correlation with disease activity, functional impairment. The main objective of this study to determine Vitamin D level in Rheumatoid Arthritis (RA) patient and healthy controls and to estimate the prevalence of Vitamin D deficiency in patients in Rheumatoid Arthritis (RA) as compared to healthy controls and to analyze the association between 25-hydroyvitamin D (25(OH) D)with disease activity. The study includes 50 RA patients (case) and 50 (controls), from Rajiv Gandhi Hospital & Research Center from duration 2012-2015.All enrolled patients had serum 25(OH) D measured in a laboratory under set conditions. The percentage of RA patients with vitamin D deficiency (25(OH) D level <20 ng/ml) was 33.5%, where as in control group percentage observed was (18.6 %). In RA patients, 25(OH) D levels were negatively correlated with the Health Assessment Questionnaire Disability Index, Disease Activity Score (DAS28), and Mobility Activities of daily living score. Significantly lower 25(OH) D values were found in patients not in disease remission or responding poorly to treatment, and with the highest Stein rocker functional state. It was also found that Body mass index (BMI) was good predictors of 25(OH) D values (P < 0.001). The association between disease activity or functional scores and 25(OH) D levels remained statistically significant even after adjusting 25(OH) D levels for both BMI. In RA patient's vitamin D deficiency is quite common, disease activity and disability scores are inversely related to 25(OH) D levels. The study concluded Overweight RA patients, with high BMI and raised DAS score and disable RA patients has low titers of Vitamin D deficiency and the same could be a proposed cause for rapid bone loss in RA patients besides autoimmune factor. Based on the merits of results obtained this study may be a recommended guideline in management of RA patients, where it is proposed that Vitamin D supplementation should be included in Reverse pyramid regimen in management of RA patients and regular monitoring of Vitamin D levels every 6 months should be emphasized for PCP .
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