Session Information
Date: Sunday, November 5, 2017
Title: Osteoporosis and Metabolic Bone Disease – Clinical Aspects and Pathogenesis Poster I
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: In 2011, we evaluated serum vitamin D levels in Japanese patients with rheumatoid arthritis (RA) and reported the prevalence of, and factors associated with, vitamin D deficiency [1]. Limited data exist in the literature concerning factors that predispose patients with RA to a worsening vitamin D deficiency. The aim of this study was to investigate predictive factors for a worsening vitamin D deficiency using our Institute of Rheumatology Rheumatoid Arthritis (IORRA) cohort.
Methods: Established in the year 2000, the IORRA cohort is a single institute-based large cohort of Japanese RA patients. Over 120 publications have described various characteristics of Japanese patients with RA using this large cohort. In 2013, fresh serum from those patients who participated in our first vitamin D study in 2011 was evaluated for 25-hydroxyvitamin D [25(OH)D] levels via radioimmunoassay. A vitamin D deficiency was defined as serum 25(OH)D levels <20 ng/mL. To determine the predictive factors of a worsening vitamin D deficiency over a 2-year period, multivariate logistic regression analyses were used.
Results: Among the 2534 patients with RA who participated in our vitamin D studies in 2011 and 2013 (2179 women and 355 men; mean age 59.6 years), the mean (± standard deviation) serum 25(OH)D level was 18.0 (±5.8) ng/mL, and the prevalence of vitamin D deficiency was 68.2% in 2013. Via multivariate analysis, younger age, female gender, and a high score for the Japanese version of the Health Assessment Questionnaire disability index (J-HAQ-DI) were significantly associated with vitamin D deficiency (P<0.05). Serum vitamin D levels decreased by >5 ng/mL over the 2 years from 2011 to 2013 in 224 (8.8%) patients. For that subset of patients, a multivariate analysis revealed, younger age, female gender, bisphosphonate disuse, and higher baseline serum 25(OH)D levels were significantly associated with the decrease in vitamin D levels over the two years (P<0.05) (Table).
Conclusion: In Japanese patients with RA, younger age, female gender, bisphosphonate disuse, and a high baseline serum 25(OH)D level appear to be associated with serum vitamin D levels that worsen over time.
Table:Factors associated with a further decrease in serum 25(OH)D levels in Japanese patients with RA from 2011 to 2013.
|
Variables |
Odds ratio (95% CI) |
P |
|
Age |
0.981 (0.964-0.999) |
0.0338 |
|
Female gender |
2.190 (1.100-4.360) |
0.0254 |
|
Bisphosphonate use |
0.431 (0.201-0.925) |
0.0308 |
|
Baseline serum vitamin D levels |
1.310 (1.27-1.35) |
<0.0001 |
Reference: 1) Clin Rheumatol. 2013; 32: 1081-7.
To cite this abstract in AMA style:
Nakayama M, Furuya T, Inoue E, Tanaka E, Ikari K, Nakajima A, Taniguchi A, Yamanaka H. Factors Associated with Worsening Serum Vitamin D Deficiencies in Japanese Patients with Rheumatoid Arthritis: Results from the IORRA Cohort Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/factors-associated-with-worsening-serum-vitamin-d-deficiencies-in-japanese-patients-with-rheumatoid-arthritis-results-from-the-iorra-cohort-study/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/factors-associated-with-worsening-serum-vitamin-d-deficiencies-in-japanese-patients-with-rheumatoid-arthritis-results-from-the-iorra-cohort-study/