Evaluation Of 25-Hydroxyvitamin D Levels in Rheumatologic Diseases

BRANCE ML; BRUN LUCAS; LARROUDE MS; SACNUN MP; AESCHLIMANN C; BERBOTTO G; PALATNIK M; CHAVERO I; SANCHEZ A

Washintgon

Congreso; American College of Rheumatology Annual Meeting; 2016

American College of Rheumatology

Background: Previous evidence indicates an associationbetween vitamin D deficiency and autoimmune diseases. The aim of this study wasto evaluate serum 25 hydroxyvitamin D (25OHD) and bone mineral density (BMD) inpatients with rheumatologic diseases (RD) in Argentinean patients. In addition,25OHD levels were analyzed in function of disease activity. Methods: This retrospective study evaluated 106 patients with RD (64 with rheumatoidarthritis (RA), 12 spondyloarthropathies (SA), 13 systemic lupus erythematosus (SLE) and 17 other collagenopathies (OC) [vasculitis, scleroderma, indiferenciateted disease connective tissue, superposition syndromeof connective tissue disease]) and was compared with a control group (CG,n=102) matched by age (CG= 55.82±1.48 years; RD= 55.28±1.30, sex and body mass index. All the patients were from Rosario (32º52´18´´S)and Buenos Aires (34º36´14´´S) cities. Exclusion criteria: supplemented withvitamin D, pregnancy, intestinal malabsorption, chronic liver or kidney diseaseor cancer. Date are expressed as mean±SEM. Differences between groups were analyzed usingthe Mann?Whitney or Kruskal?Wallis test. Correlationswere performed with Spearman?s correlation test. The difference was consideredsignificant if p<0.05. Results: No differences between groups were observed in serum calcium,phosphatemia, urinary calcium, parathormone and urinary deoxipiridinoline.Significant differences were found in alkaline phosphatase (CG= 102.90±5.40 UI/l; RD= 167.2±8.59) and 25OHD (CG= 25.64±1.06 ng/ml; RD= 19.17±0.66). 25OHD significantly correlated with erythrocyte sedimentationrate (ERS) [r= -0.26] and reactive C-protein (RCP) [r = -0.27] as acute phasereactants. RD patients had significantlower 25OHD levels (RA= 19.89±0.81; SA=15.64±1.76; SLE= 19.81±2.49; and OC= 18.44±1.48) than CG (25.64±1.06 ng/ml). No correlation between 25OHD levels and DAS-28 and HAQ-DIscores were found. However, lower values of 25OHD were found at higher scores:HAQ-20 ≤2= 22.41±1.45 ng/ml, HAQ-20 >2= 18.80±0.95, p=0.047; DAS28 ≤3.2=21.43±1.62 ng/ml, DAS28 >3.2= 19.78±0.95l, p=0.157. Activity scores inothers RD couldn´t be analyzed because small number of patients. No significantdifferences were found in lumbar spine BMD between premenopausal or postmenopausal(postM) patients, but femoral neck BMD was significantly lower in postM RD patients(0.775±0.026 g/cm2; T-score −1.94±0.20) than in postM CG patients(0.802±0.020; T-score −1.24±0.16). Conclusion: In both groups 25OHD levels wereunder 30 ng/ml. However, 25OHD levels were lower in RD patients (deficiency) thanCG (insufficiency). Lower values of 25OHD werefound at higher ERS and RCP in all RD and at higher activity disease scores in RA.