Vitamin D status in patients with rheumatoid arthritis: correlation analysis with disease activity and progression, as well as serum IL-6 levels
Objectives. Recent epidemiological studies suggested an association between a poor vitamin D [25(OH)D] status, inflammatory mediators, and rheumatoid arthritis (RA). We have recently proposed that pro-inflammatory interleukin 6 (IL-6) may represent a good marker for disease activity of RA (Acta Biochim Pol 57: 327-32). The aim of the study was to investigate the relationship between serum 25(OH)D levels and disease activity, joint damage, as well as serum IL-6 levels in a Polish RA population. Materials and methods. Serum 25(OH)D levels were measured in 35 female RA patients and 38 age- and gender-matched healthy controls. Statistical correlations between 25(OH)D levels and disease activity score 28 (DAS 28), joint damage based on Steinbrocker criteria, as well as serum IL-6 levels were performed. Results. There was no statistical significant difference between levels of 25(OH)D in RA (16.89 ± 8.57 ng/ml) and healthy controls (14.12 ± 7.51 ng/ml) and the vitamin D deficiency (<20 ng/ml) was found in 71.43% of RA patients and 73.68 % of healthy controls. While vitamin D status did not correlate with DAS 28 (r= 0.265, p=0.149) and joint damage based on Steinbrocker criteria (r=0.367, p=0.065), a positive correlation between 25(OH)D and IL-6 (r=0.537, p=0.002) was observed in RA. Conclusion. Hypovitaminosis D is common in RA patients and middle-aged non-RA healthy women in the Polish population. 25(OH)D levels were similar in RA patients and age- and gender-matched healthy controls and were not associated with joint damage and disease activity in patients.
Alluno A, Manetti M, Caterbi S, Ibba-Manneschi L, Bistoni O, Bartoloni E, Valentini V, Terenzi R, Gerli R (2015) Altered immunoregulation In rheumatoid arthritis: the role of regulatory T cells and proinflammatory Th17 cells and therapeutic implication. Mediators Inflamm 751793. http://doi.org/10.1155/2015/751793
Baker J, Baker D, Toedter G, Shults J, Von Feldt J, Leonard M (2012) Associations between vitamin D, disease activity and clinical response to therapy in rheumatoid arthritis. Clin Exp Rheumatol 30: 658-664.
Braun-Muscovici Y, Toledano K, Markovits D, Rozin A, Nahir A, Balbir-Gurman A (2011) Vitamin D level: is it related to disease activity In inflammatory joint disease? Rheumatol Int 31: 493-499. http://doi.org/10.1007/s00296-009-1251-6
Chaudhari K, Rizvi S, Syed BA (2016) Rheumathoid arthritis: current and future trends. Nat Rev Drug Discov 15: 305-306. http://doi.org/10.1038/nrd.2016.21
Craig S, Yu F, Curtis J, Alarcón G, Conn D, Jonas B, Callahan LF, Smith EA, Moreland LW, Bridges SL, Jr, Mikuls TR (2010)Vitamin D status and its associations with disease activity and severity in African Americans with recent-onset rheumatoid arthritis. J Rheumatol 37: 275-281. http://doi.org/10.3899/jrheum.090705
Cutolo M, Otsa K, Laas K, Yprus M, Lethme R, Secchi M, Sulli A, Paolino S, Seriolo B (2006) Circannual vitamin D serum levels and disease activity in rheumatoid arthritis: Northern versus Southern Europe. Clin Exp Rheumatol 24: 702-704.
Hall AC, Juckett MB (2013) The role of vitamin D in hematologic disease and stem cell transplantation. Nutrients 5: 2206-2221. http://doi.org/10.3390/nu5062206
Haque U, Barlett S (2010) Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. Clin Exp Rheumatol 28: 745-747.
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, Murad MH, Weaver CM (2011) Evaluation, treatment and orevention of vitamin D deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96: 1911-1930. http://doi.org/10.1210/jc.2011-0385
Hong Q, Xu J, Xu S, Lian L, Zhang M, Ding C (2014) Associations between serum 25-hydroxyvitamin D and disease activity, inflammatory cytokines and bone loss in patients with rheumatoid arthritis. Rheumatology (Oxford) 53: 1994-2001. http://doi.org/10.1093/rheumatology/keu173
Jeffery LE, Raza K, Hewison M (2016) Vitamin D in rheumathoid arthritis-towards clinical application. Nat Rev Rheumatol 12: 201-210. http://doi.org/10.1038/nrrheum.2015.140
Kerr G, Sabahi I, Richard J, Caplan L, Cannon G, Reimold A, Thiele GM, Jonhson D, Mikuls TR (2011) Prevalence of vitamin D insufficiency/deficiency in rheumatoid arthritis and association with disease severity and activity. J Rheumatol 38: 53-59.
Kmieć P, Sworczak K (2015) Vitamin D deficiency in early autumn among predominantly non-elderly, urban adults in Northern Poland (54°N). Postepy Hig Med Dosw 69: 918-924. http://doi.org/10.5604/17322693.1165194
Kostoglou-Athenassiou I, Athanassiou P, Lyraki A, Raftakis I, Antoniadis C (2012) Vitamin D and rheumatoid arthritis. Ther Adv Endocrinol Metab 3: 181-187. http://doi.org/10.5604/17322693.1165194
Lin J, Liu J, Davies ML, Chen W (2016) Serum Vitamin D Level and Rheumatoid Arthritis Disease Activity: Review and Meta-Analysis. PLoS One 11: e0146351. http://doi.org/10.1371/journal.pone.0146351
Mateen S, Moin S, Shahzad S, Khan A (2017) Level of inflammatory cytokines in rheumatoid arthritis patients: Correlation with 25-hydroxy vitamin D and reactive oxygen species. PLoS One 12: e0178879. http://doi.org/10.1371/journal.pone.0178879
Płudowski P, Ducki C, Konstantynowicz J, Jaworski M (2016) Vitamin D status in Poland. Pol Arch Med Wewn 126: 530-9. http://doi.org/10.20452/pamw.3479
Racovan M, Walitt B, Collins CE, Pettinger M, Parks CG, Shikany JM, Wactawski-Wende J, Manson JE, Moreland L, Wright N, Jackson R, Howard BV (2012) Calcium and vitamin D supplementation and incident rheumatoid arthritis: the women’s health initiative calcium plus vitamin D trial. Rheumatol Int 32: 3823- 3830. http://doi.org/10.1007/s00296-011-2268-1
Raczkiewicz A, Kisiel B, Kulig M, Tłustochowicz W (2015) Vitamin D status and its association with quality of life, physical activity, and disease activity in rheumatoid arthritis patients. J Clin Rheumatol 21: 126:130. http://doi.org/10.1097/RHU.0000000000000233
Rossini M, Maddali BS, La Montagna G, Minisola G, Malavolta N, Bernini L, Cacace E, Sinigaglia L, Di Munno O, Adami S (2010) Vitamin D deficiency In rheumatoid arthritis: prevalence, determinants and associations with disease activity and disability. Arthritis Res Ther 12: R216. http://doi.org/10.1186/ar3195
Sahebari M, Mirfeizi Z, Rezaieyazdi Z, Rafafpanah H, Goshyeshi L (2014) 1,25(OH) vitamin D serum values and rheumatoid arthritis disease activity. Caspian J Intern Med 5: 148-155.
Singh JA, Saag KG, Bridges SL, Akl EA, Bannuru RR, Sullivan MC, Vaysbrot E, McNaughton C, Osani M, Shmerling RH, Curtis JR, Furst DE, Parks D, Kavanaugh A, O’Dell J, King C, Leong A, Matteson EL, Schousboe JT, Drevlow B, Ginsberg S, Grober J, St Clair EW, Tindall E, Miller AS, McAlindon T (2016) 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Rheumatol 68: 1-26. http://doi.org/10.1002/art.39480
Tukaj S, Kotlarz A, Jóźwik A, Smoleńska Z, Bryl E, Witkowski JM, Lipińska B (2010) Cytokines of the Th1 and Th2 type in sera of rheumatoid arthritis patients; correlations with anti-Hsp40 immune response and diagnostic markers. Acta Biochim Pol 57: 327-32.
Turhanoflu AD, Güler H, Yönden Z, Aslan F, Mansuroglu A, Ozer C (2011) The relationship between vitamin D and disease activity and functional health status in rheumatoid arthritis. Rheumatol Int 31: 911-914. http://doi.org/10.1007/s00296-010-1393-6
Welsh P, Peters M, McInnes I, Lems W, Lips P, McKellar G, Knox S, Wallace AM, Dijkmans BAC, Nurmohamed MT, Sattar N (2011) Vitamin D deficiency is common in patients with RA and linked to disease activity, but circulating levels are unaeffects by TNFα blockade: results from a prospective cohort study. Ann Rheum Dis 70: 1165-1167. http://doi.org/10.1136/ard.2010.137265.
Yang CY, Leung PS, Adamopoulos IE, Gershwin ME (2013) The implication of vitamin D and autoimmunity: a comprehensive review. Clin Rev Allergy Immunol 45: 217-26. http://doi.org/10.1007/s12016-013-8361-3
Yusof MY, Emery P (2013) Targeting interleukin-6 in rheumatoid arthritis. Drugs 73: 341-56. http://doi.org/10.1007/s40265-013-0018-2
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