Date: Sunday, November 5, 2017
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: Previous evidence indicates an association between vitamin D deficiency and autoimmune diseases. The aim of this study was to evaluate serum 25-hydroxyvitamin D (25OHD), acute phase reactants and disease activity in patients with rheumatologic diseases (RD).
Methods: This retrospective study evaluated 173 patients with RD (94 rheumatoid arthritis (RA), 18 spondyloarthropathies (SA), 61 collagenopathies (COL) (systemic lupus erythematosus, vasculitis, scleroderma, undifferentiated disease, superposition syndrome) and compared them with a control group (CG, n=121) matched by age (CG= 55.0±14.7 years; RD= 53.4±13.6, sex and body mass index (BMI). All patients were from Rosario (32º52´18´´S) and Buenos Aires (34º36´14´´S) cities. Exclusion criteria: supplementation with vitamin D, pregnancy, intestinal malabsorption, chronic liver or kidney disease, and cancer. Date are expressed as mean±SEM. Differences between groups were analyzed using the Mann-Whitney or Kruskal-Wallis tests. Correlations were performed with Spearman’s correlation test. Univariate linear regression and logistic regression analysis were performed. Contingency tables were evaluated with χ2 test. The difference was considered significant if p<0.05.
Results: RD patients had significant lower 25OHD levels as a control group (CG= 26.8±1.1 ng/ml; RD= 19.8±0.6 ng/ml; p<0.0001). Furthermore, all subgroups had lower 25OHD (RA=20.7±0.7 ng/ml, SA= 15.4±1.3 ng/ml, COL= 19.7±1.1 ng/ml). The OR of patients with RD being vitamin D deficient (25OHD <20 ng/ml) was 2.7 (95%CI 1.6 to 4.4) with a probability of 73%. Consistent with 25OHD differences, significant lower serum calcium (CG= 9.33±0.04; RD= 9.14±0.08 mg/dl) and higher PTH (CG= 39.72±2.37; RD= 49.93±3.34 pg/ml) levels were found. No differences in serum phosphate, urinary calcium and urinary deoxipiridinoline were observed. 25OHD significantly correlated with erythrocyte sedimentation rate (ERS) [r= -0.28; p=0.0017] as acute phase reactants. No differences was found in reactive C-protein (RCP). Lower values of 25OHD were found at higher DAS-28 (<3.2= 22.9 ng/ml; 3.2-5.1= 19.8 ng/ml; >5.1= 19.9 ng/ml; p=0.23) and HAQ-DI (0-1= 22.9 ng/ml; 2= 19.8 ng/ml; 3= 19.9 ng/ml; p=0.001). Activity scores in other RD couldn´t be analyzed because of the small number of patients. Age, BMI, presence of RD, RCP and HAQ-DI were significantly and inversely associated with 25OHD levels. BMI, presence of RD, ERS and RCP were significantly associated with vitamin D deficiency.
Conclusion: Patients with RD have a high probability of being deficient in 25OHD. Low 25OHD levels are associated with high acute phase reactants in the whole group, and with high disease activity scores in RA patients.
To cite this abstract in AMA style:Brance ML, Brun LR, Larroude M, Sacnun MP, Aeschlimann C, Berbotto G, Palatnik M, Chavero I, Sánchez A. Serum 25-Hydroxyvitamin D, Acute Phase Reactants and Disease Activity in Rheumatologic Diseases [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/serum-25-hydroxyvitamin-d-acute-phase-reactants-and-disease-activity-in-rheumatologic-diseases/. Accessed September 19, 2021.
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