Vitamin D deficiency in chronic inflammatory rheumatic diseases: results of the cardiovascular in rheumatology [CARMA] study
IntroductionThe 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).MethodsWe 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.Results2.234 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.ConclusionsPatients with RA show an increased risk of having 25(OH)D deficiency compared to non CIRD controls.
Arthritis Research Therapy