Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: To investigate the status of vitamin D in patients with early inflammatory arthritis (EIA) compared with healthy controls.
Methods: The study included 101 patients with EIA (≥ 1 swollen joint, symptom duration of ≤ 6 months, not explained by another disease) and 101 healthy controls matched for age, gender and the month of serum vitamin D measurements, not receiving vitamin D supplementation, at a university-affiliated rheumatology center in South Korea from March 2012 to February 2013. Serum 25(OH) vitamin D levels were assessed by radioimmunoassay. EIA patients were subdivided into rheumatoid arthritis (RA) and non-RA according to the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) criteria. Results: No significant difference in serum 25(OH) vitamin D levels between EIA and controls was observed (median 14.2 vs 16.3, p=0.229, Table 1). Among 101 EIA patients, 38 subjects (37.1%) were categorized as RA. In subgroup analyses of EIA patients, RA patients had significantly higher swollen joint count (SJC), tender joint count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-citrullinated protein antibody (ACPA) and lower serum 25(OH) vitamin D levels than in non-RA subjects. Serum 25(OH) vitamin D levels in EIA patients were inversely correlated with the titer of ACPA (ρ=-0.214, p=0.031), SJC (ρ=-0.196, p=0.049) and patient’s visual analogue scale (ρ=-0.202, p=0.043). Low serum 25(OH) vitamin D levels in EIA patients tended to be related to a greater likelihood of fulfilling the 2010 ACR/EULAR criteria after adjusting age, sex, Health Assessment Questionnaire score and season (OR=0.952, 95% CI=0.905-1.001, p=0.054, Table 2). In particular, multivariable logistic regression analysis showed that severe vitamin D deficiency (25(OH) vitamin D < 10ng/mL) was significantly associated with the diagnosis of RA (OR=3.259, 95% CI=1.137-9.342, p=0.028, Table 2).
Conclusion: Although serum vitamin D levels in EIA patients were similar to those of controls, vitamin D deficiency contributed to the presence of RA in EIA patients.
Table 1. Demographics and disease characteristics of patients with early inflammatory arthritis and healthy controls
|
Variables |
EIA (n=101) |
Controls (n=101) |
|
Age, years |
56.5 ± 12.2 |
56.6 ± 12.1 |
|
Female, n (%) |
86 (85.1) |
86 (85.1) |
|
Serum (OH) vitamin D, ng/mL |
14.2 (5.5-67.9) |
16.3 (4.6-23.3) |
|
Severe vitamin D deficiency (<10 ng/mL), n (%) |
18 (17.8) |
15 (14.9) |
|
Diagnosis |
|
|
|
RA, n (%)1 |
38 (37.6) |
|
|
Non –RA, n (%) |
63 (62.4) |
|
|
OA, n (%) |
37 (36.7) |
|
|
UIA, n (%) |
24 (23.1) |
|
|
Other, n (%) |
2 (2.0) |
|
EIA, inflammatory early arthritis; RA, rheumatoid arthritis; OA, osteoarthritis; UIA, undifferentiated arthritis.
1 RA was classified as 2010 ACR/EULAR criteria.
Table 2. Association between serum 25 (OH) vitamin D and the presence of rheumatoid arthritis in early inflammatory arthritis
|
Variables |
Crude OR (95% CI) |
p-value |
Adjusted OR (95% CI) |
p-value |
|
Serum 25(OH) vitamin D, ng/mL, |
0.95 (0.91-1.00)
|
0.054 |
0.95 (0.91-1.00)1
|
0.054 |
|
Severe vitamin D deficiency (<10 ng/mL) |
3.26 (1.14-9.34)
|
0.028 |
3.26 (1.14-9.34)1
|
0.028 |
|
Age, years |
1.00 (0.98-1.04) |
0.612 |
|
|
|
Female vs male |
0.89 (0.29-2.73) |
0.837 |
|
|
|
HAQ |
1.85 (0.96-3.53) |
0.064 |
|
|
|
Season |
|
|
|
|
|
Spring |
1.0 |
|
|
|
|
Summer |
0.37 (0.12-1.12) |
0.078 |
|
|
|
Autumn |
0.37 (0.12-1.12) |
0.078 |
|
|
|
Winter |
0.31 (0.10-1.00) |
0.050 |
|
|
1 Estimated using multivariable logistic regression analyses with backward selection, adjusted for age, sex, HAQ and season.
Disclosure:
S. G. Lee,
None;
G. T. Kim,
None;
J. W. Lee,
None;
S. H. Kim,
None;
S. H. Baek,
None.
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