Vitamin D in Rheumatic Diseases: Interpretation and Significance (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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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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Vitamin D and Rheumatic Diseases: A Review of Clinical Evidence
International Journal of Molecular Sciences
Vitamin D plays an important role in maintaining a healthy mineralized skeleton. It is also considered an immunomodulatory agent that regulates innate and adaptive immune systems. The aim of this narrative review is to provide general concepts of vitamin D for the skeletal and immune health, and to summarize the mechanistic, epidemiological, and clinical evidence on the relationship between vitamin D and rheumatic diseases. Multiple observational studies have demonstrated the association between a low level of serum 25-hydroxyvitamin D [25(OH)D] and the presence and severity of several rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies, and osteoarthritis (OA). Nevertheless, the specific benefits of vitamin D supplements for the treatment and prevention of rheumatic diseases are less accepted as the results from randomized clinical trials are inconsistent, although some conceivable benefits of vitamin D for the improvemen...
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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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2014
Objective: To estimate serum level of active vitamin D in patients with rheumatoid arthritis and to assess the impact of vitamin D deficiency on disease severity and activity. Methods: Pilot study included 35 rheumatoid arthritis patients in the first 2 years of disease onset compared with 30 healthy age and sex matched controls. Assessment of serum vitamin D level was done at baseline for both patients and controls, accordingly patients were classified as group I (with vitamin D deficiency) and group II (with vitamin D insufficiency). At baseline, patients were subjected to full history taking, clinical examination with assessment of disease activity and functional ability, complete blood picture, liver enzymes, kidney functions and rheumatoid factor (IgM). Follow-up every three months for one year was done for rheumatoid patients. Each time reassessment using DAS28 score, Erythrocyte sedimentation rate (ESR) and quantitative C-reactive protein (CRP) titer for activity and Health A...
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