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Arthritis Research and Therapy

, 12:R216

First Online: 29 November 2010Received: 12 October 2010Revised: 14 November 2010Accepted: 29 November 2010


IntroductionThe aim of this study was to estimate the prevalence and determinants of vitamin D deficiency in patients with rheumatoid arthritis RA as compared to healthy controls and to analyze the association between 25-hydroxyvitamin D 25OHD with disease activity and disability.

MethodsThe study includes 1,191 consecutive RA patients 85% women and 1,019 controls, not on vitamin D supplements, from 22 Italian rheumatology centres. Together with parameters of disease activity, functional impairment, and mean sun exposure time, all patients had serum 25OHD measured in a centralized laboratory.

ResultsA total of 55% of RA patients were not taking vitamin D supplements; the proportion of these with vitamin D deficiency 25OHD level <20 ng-ml was 52%. This proportion was similar to that observed in control subjects 58.7%. One third of supplemented patients were still vitamin D deficient. In non-supplemented RA patients 25OHD levels were negatively correlated with the Health Assessment Questionnaire Disability Index, Disease Activity Score DAS28, and Mobility Activities of daily living score. Significantly lower 25OHD values were found in patients not in disease remission or responding poorly to treatment, and with the highest Steinbrocker functional state. Body mass index BMI and sun exposure time were good predictors of 25OHD values P < 0.001. The association between disease activity or functional scores and 25OHD levels remained statistically significant even after adjusting 25OHD levels for both BMI and sun exposure time.

ConclusionsIn RA patients vitamin D deficiency is quite common, but similar to that found in control subjects; disease activity and disability scores are inversely related to 25OHD levels.

Abbreviations25OHD25-hydroxyvitamin D

ACRAmerican College of Rheumatology

ADLactivities of daily living

ANCOVAanalysis of covariance

ANOVAanalysis of variance

Anti-CCPanti Cyclic Citrullinated Peptide

Anti-TNFtumor necrosis factor α blocker

BMIbody mass index

CRPC-reactive protein

DAS 28Disease Activity Score 28

DMARDsdisease modifying antirheumatic drugs

HAQHealth Assessment Questionnaire Disability Index

PTHparathyroid hormone

RArheumatoid arthritis

RFrheumatoid factor

SJC2828 swollen joint count

TJC2828 tender joint count.

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Autor: Maurizio Rossini - Susanna Maddali Bongi - Giovanni La Montagna - Giovanni Minisola - Nazzarena Malavolta - Luigi Bernini -


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