Vitamin D deficiency in chronic inflammatory rheumatic diseases: results of the cardiovascular in rheumatology [CARMA] study

Arthritis Research & Therapy - Tập 17 - Trang 1-10 - 2015
Ana Urruticoechea-Arana1, María A. Martín-Martínez2, Santos Castañeda3, Carlos A. Sanchez Piedra2, Carlos González-Juanatey4, Javier Llorca5, Federico Díaz-Gonzalez2,6,7, Miguel A. González-Gay8,9
1Division of Rheumatology, Hospital Can Misses, Ibiza, Spain
2Research Unit of Spanish Society of Rheumatology, Calle Marqués del Duero, Madrid, Spain
3Division of Rheumatology, Hospital U de la Princesa, Madrid, Spain
4Division of Cardiology, Hospital Lucus Augusti, Lugo, Spain
5Division of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, CIBER Epidemiología y Salud Pública (CIBERESP), Santander, Spain
6Research Unit of Spanish Society of Rheumatology, Madrid, Spain
7School of Medicine, Universidad de La Laguna, Tenerife, Spain
8Division of Rheumatology, Hospital Universitario de Canarias, La Laguna, Spain
9Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, Santander, and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Rheumatology Division, IDIVAL, Santander, Spain

Tóm tắt

The aim was to study the association between 25-hydroxyvitamin D (25(OH)D) levels and the clinical characteristics of patients with chronic inflammatory rheumatic diseases (CIRD). We studied a cross-section from the baseline visit of the CARMA project (CARdiovascular in rheuMAtology), a 10-year prospective study evaluating the risk of cardiovascular events in rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients, and non-CIRD patients who attended rheumatology outpatient clinics from 67 hospitals in Spain. Non-CIRD group was frequency matched by age with the joint distribution of the three CIRD groups included in the study. 25(OH)D deficiency was defined if 25(OH)D vitamin levels were < 20 ng/ml. 2.234 patients (775 RA, 738 AS and 721 PsA) and 677 non-CIRD subjects were assessed. The median (p25-p75) 25(OH)D levels were: 20.4 (14.4-29.2) ng/ml in RA, 20.9 (13.1-29.0) in AS, 20.0 (14.0-28.8) in PsA, and 24.8 (18.4-32.6) ng/ml in non-CIRD patients. We detected 25(OH)D deficiency in 40.5 % RA, 39.7 % AS, 40.9 % PsA and 26.7 % non-CIRD controls (p < 0.001). A statistically significant positive association between RA and 25(OH)D deficiency was found (adjusted (adj.) OR = 1.46; 95 % CI = 1.09-1.96); p = 0.012. This positive association did not reach statistical significance for AS (adj. OR 1.23; 95 % CI = 0.85-1.80) and PsA (adj. OR 1.32; 95 % CI = 0.94-1.84). When the parameters of disease activity, severity or functional impairment were assessed, a marginally significant association between 25(OH)D deficiency and ACPA positivity in RA patients (adj. OR = 1.45; 95 % CI = 0.99-2.12; p = 0.056), and between 25(OH)D deficiency and BASFI in AS patients (adj. OR = 1.08; 95 % CI = 0.99-1.17); p = 0.07) was also found. Patients with RA show an increased risk of having 25(OH)D deficiency compared to non-CIRD controls.

Tài liệu tham khảo

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