Journal of Postgraduate Medicine, Education and Research

Register      Login

VOLUME 51 , ISSUE 4 ( October-December, 2017 ) > List of Articles

RESEARCH ARTICLE

Vitamin D Deficiency in Rheumatoid Arthritis and Vitamin D Levels that vary with Rheumatoid Arthritis Severity: An Indian Study

Muzamil Latief, Farhat Abbas, Amandeep Minhas, Waseem Dar, Manzoor Parry, Purshotam D Gupta

Citation Information : Latief M, Abbas F, Minhas A, Dar W, Parry M, Gupta PD. Vitamin D Deficiency in Rheumatoid Arthritis and Vitamin D Levels that vary with Rheumatoid Arthritis Severity: An Indian Study. J Postgrad Med Edu Res 2017; 51 (4):162-165.

DOI: 10.5005/jp-journals-10028-1256

Published Online: 00-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease characterized by periods of remission and flares of symmetrical joint inflammation slowly progressing to joint and cartilage destruction leading to deformities. Evidence is accumulating suggesting vitamin D deficiency and its correlation in autoimmune diseases including RA.

Aims of study

(1) Estimation of vitamin D levels in RA patients. (2) Correlation of vitamin D levels with severity of the disease.

Materials and methods

A study population of 50 included 25 cases and 25 controls. Both males and females of 30 to 40 years of age were taken for this study. Patients of RA having any other autoimmune disease were excluded. Twenty-five healthy adults, whose ages were between 30 and 40 years, both male and female, free from any systemic illness were taken as controls. Routine systematic examination and detailed joint examination were done. Disease activity was measured in patients of RA according to Disease Activity Score (DAS-28). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), and anticyclic citrullinated peptide (CCP) among other routine blood investigations were done.

Results

In cases, the mean vitamin D level was 18.41 ng/mL with standard deviation (SD) of 7.10, while controls had mean level as 22.32 ng/mL with SD as 4.80. The difference between the two was recorded as statistically significant, i.e., p-value <0.05. While 4 (16.0%) patients had low severity, 15 (60.0%) had moderate severity, and 6 (24.0%) patients had high severity of disease as per DAS-28. Patients whose RA disease activity was high had lower vitamin D levels.

Conclusion

It is thus concluded that in RA patients the serum vitamin D levels are significantly lower than in healthy control, and vitamin D deficiency may be one of the causes contributing to worsening of RA.

How to cite this article

Latief M, Abbas F, Minhas A, Dar W, Parry M, Gupta PD. Vitamin D Deficiency in Rheumatoid Arthritis and Vitamin D Levels that vary with Rheumatoid Arthritis Severity: An Indian Study. J Postgrad Med Edu Res 2017;51(4):162-165.


PDF Share
  1. Status of serum vitamin D levels in patients of rheumatoid arthritis: a pilot study. J Rational Pharmacother Res 2014 Apr;2(3):90-95.
  2. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014 Feb;73(7):1316-1322.
  3. Vitamin D deficiency in systemic lupus erythematosus. Autoimmun Rev 2006 Feb;5(2):114-117.
  4. Vitamin D and autoimmune rheumatologic disorders. Autoimmun Rev 2010 May;9(7):507-510.
  5. Molecular basis of the potential of vitamin D to prevent cancer. Curr Med Res Opin 2008 Jan;24(1):139-149.
  6. Issues with vitamin D in routine clinical practice. Rheumatology (Oxford) 2008 Sep;47(9):1267-1268.
  7. Modulatory effects of 1,25-dihydroxy-vitamin D3 on human B cell differentiation. J Immunol 2007 Aug;179(3):1634-1647.
  8. The vitamin D receptor regulates rheumatoid arthritis synovial fibroblast invasion and morphology. Mol Med 2012 Mar;18:194-200.
  9. Involvement of the vitamin D receptor in the regulation of NF-kappaB activity in fibroblasts. J Steroid Biochem Mol Biol 2007 Mar;103(3-5):563-566.
  10. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr 2008 Apr;87(4):1080S-1086S.
  11. Hypovitaminosis D in medical inpatients. N Engl J Med 1998 Mar;338(12):777-783.
  12. The relationship between vitamin D and disease activity in Egyptian patients with rheumatoid arthritis. Int Trends Immun 2014 Jul;2(3):122-127.
  13. 25-hydroxy vitamin D and its relationship with clinical and laboratory parameters in patients with rheumatoid arthritis. Clin Rheumatol 2015 Feb;34(2):353-357.
  14. Novel biomarkers in autoimmune diseases; prolactin, ferritin, vitamin D, and TPA levels in autoimmune diseases. Ann NY Acad Sci 2007 Sep; 1109:385-400.
  15. Associations between vitamin D, disease activity, and clinical response to therapy in rheumatoid arthritis. Clin Exp Rheumatol 2012 Sep-Oct;30(5):658-664.
  16. Vitamin D level: is it related to disease activity in inflammatory joint disease? Rheumatol Int 2011 Apr;31(4):493-499.
  17. Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. Clin Exp Rheumatol 2010 Sep-Oct;28(5):745-747.
  18. Circannual vitamin d serum levels and disease activity in rheumatoid arthritis: Northern versus Southern Europe. Clin Exp Rheumatol 2006 Nov-Dec;24(6):702-704.
  19. Bacterial components plus vitamin D: the ultimate solution to the asthma (autoimmune disease) epidemic? J Allergy Clin Immunol 2011 May;127(5):1128-1130.
  20. Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol 2008 Sep;8(9):685-698.
  21. Vitamin D and immune function: autocrine, paracrine or endocrine? Scand J Clin Lab Invest Suppl 2012 Apr;243:92-102.
  22. Vitamin D: emerging roles in infection and immunity. Expert Rev Anti Infect Ther 2010 Dec;8(12):1359-1369.
  23. Bone loss in rheumatoid arthritis: systemic, periarticular, and focal. Curr Rheumatol Rep 2012 Jun;14(3):231-237.
  24. Determinants and effects of vitamin D supplementation on serum 25-hydroxy-vitamin D levels in patients with rheumatoid arthritis. Clin Exp Rheumatol 2012 Sep-Oct;30(5):714-719.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.