Research Article
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Vitamin D'nin romatoid artrit üzerindeki etkisi: gerçek mi yoksa sadece hasta algısı mı?

Year 2018, Volume:3 Issue: 3, 127 - 131, 30.11.2018
https://doi.org/10.25000/acem.440559

Abstract



Amaç: Bu çalışmadaki amaçlarımız, romatoid
artrit (RA) hastalarında D vitamini düzeylerini ve D vitamini düzeylerinin
objektif ve subjektif değerlendirmelere etkisini belirlemektir.

Yöntemler: Bu çalışma, 108 RA hastası ve yaş
ve cinsiyete göre eşleştirilmiş 50 sağlıklı kontrol üzerinde yapılan bir prospektif
olgu-kontrol çalışmasıdır. Öncelikle RA hastaları ve kontroller arasında D
vitamini düzeylerini karşılaştırdık. RA hastalarının demografik ve klinik
verileri, hastalık aktivitesi parametreleri, inflamatuvar belirteçleri, romatoid
faktör ve anti-siklik sitrüllenmiş peptid seropozitifliği ve radyolojik hasar
skorları kaydedildi. Hastalardan ayrıca RA Yaşam Kalitesi Anketi (Rheumatoid
Arthritis Quality of Life, RAQoL), yorgunluk şiddet ölçeği (Fatigue Severity
Scale, FSS) ve Sağlık Değerlendirme Anketi (Health Assessment Questionnaire, HAQ)
tamamlamaları istendi.

Bulgular: RA hastalarında D vitamin düzeyleri
sağlıklı kontrollerden anlamlı derecede düşüktü (p=0,001). RA hastalarının %
73'ünde ve kontrollerin % 52'sinde D vitamini eksikliği tespit edildi. D
vitamini eksikliği, hastalık aktivitesi ile ilişkili değildi (p=0,862). D
vitamini seviyeleri ile tüm subjektif ve objektif değerlendirmeler arasında
anlamlı bir ilişki bulunamadı (hepsi için p>0,050).







Sonuç:  D
vitamini eksikliği RA hastalarında normal popülasyona göre daha sık
görülmektedir.  Ancak, vitamin D
düzeyleri ile hastalık aktivitesi, inflamatuvar belirteçler, romatoid faktör ve
anti-siklik sitrüllenmiş peptid seropozitifliği, radyolojik hasar skorları ve RAQoL,
FSS, HAQ ile ilişkili hastalığın objektif ve subjektif değerlendirmeleri
arasında anlamlı bir ilişki bulunduğu gösterilemedi.

References

  • 1. Hong Q, Xu J, Xu S, Lian L, Zhang M, Ding C. Associations between serum 25-hydroxyvitamin D and disease activity, inflammatory cytokines and bone loss in patients with rheumatoid arthritis. Rheumatology (Oxford). 2014; 53:1994-2001.
  • 2. Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity. J Nat Sci Biol Med. 2018;9:54-8.
  • 3. Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential. Front Immun. 2016;7:697.
  • 4. Lee YH, Bae SC. Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: a meta-analysis. Clin Exp Rheumatol. 2016;34:827-33.
  • 5. Polasik K, Piotrowska E, Lipińska B, Witkowski JM, Bryl E, Tukaj S. Vitamin D status in patients with rheumatoid arthritis: a correlation analysis with disease activity and progression, as well as serum IL-6 levels. Acta Biochim Pol. 2017;64:667-70.
  • 6. Wong TH, Gupta ED, Radhakrishnan AK, Gun SC, Chembalingam G, Yeap SS. Effects of 25-hydroxyvitamin D and vitamin D-binding protein on bone mineral density and disease activity in Malaysian patients with rheumatoid arthritis. Int J Rheum Dis. 2018;21:992-1000.
  • 7. Baker JF, Baker DG, Toedter G, Shults J, Von Feldt JM, Leonard MB. Associations between vitamin D, disease activity, and clinical response to therapy in rheumatoid arthritis. Clin Exp Rheumatol. 2012;30:658-64.
  • 8. Higgins MJ, Mackie SL, Thalayasingam N, Bingham SJ, Hamilton J, Kelly CA. The effect of vitamin D levels on the assessment of disease activity in rheumatoid arthritis. Clin Rheumatol. 2013;32:863-7.
  • 9. van der Linden MP, Knevel R, Huizinga TW, van der Helm-van Mil AH. Classification of rheumatoid arthritis: Comparison of the 1987 American College of Rheumatology criteria and the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Arthritis Rheum. 2011;63:37–42.
  • 10. De Jong Z, van der Heijde D, McKenna S, Whalley D. Development and validation of a RA‐specific quality of life measure (RAQoL). Arthritis Rheum. 1995;38:175.
  • 11. Tijhuis GJ, de Jong Z, Zwinderman AH, Zuijderduin WM, Jansen LM, Hazes JM, et al. The validity of the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire. Rheumatology (Oxford). 2001 40:1112–9.
  • 12. Krupp LB. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.
  • 13. Bruce B, Fries J: The Stanford health assessment questionnaire (HAQ): a review of its history, issues, progress, and documentation. J Rheumatol. 2003;30:167-78.
  • 14. van der Heijde D. How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol. 2000;27:2613.
  • 15. Hajjaj-Hassouni N, Mawani N, Allali F, Rkain H, Hassouni K, Hmamouchi I,et al. Evaluation of Vitamin D Status in Rheumatoid Arthritis and Its Association with Disease Activity across 15 Countries: “The COMORA Study.” Int J Rheumatol. 2017;2017:5491676.
  • 16. Chandrashekara S, Patted A. Role of vitamin D supplementation in improving disease activity in rheumatoid arthritis: An exploratory study. Int J Rheum Dis. 2017;20:825-31.
  • 17. Quintana-Duque MA, Caminos JE, Varela-Nariño A, Calvo-Paramo E, Yunis JJ, Iglesias-Gamarra A. The Role of 25-Hydroxyvitamin D as a Predictor of Clinical and Radiological Outcomes in Early Onset Rheumatoid Arthritis. J Clin Rheumatol. 2017;23:33-9.
  • 18. Fransen J, van Riel PL. The disease activity score and the EULAR response criteria. Clin Exp Rheumatol. 2005;23:93–9.
  • 19. Franco AS, Freitas TQ, Bernardo WM, Pereira RMR. Vitamin D supplementation and disease activity in patients with immune-mediated rheumatic diseases: A systematic review and meta-analysis. Medicine. 2017;96:e7024.
  • 20. Cantorna MT, Hayes CE, Deluca HF. 1,25-Dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis. J Nutr. 1998;128:68–72.
  • 21. Bragazzi NL, Watad A, Neumann SG, Simon M, Brown SB, Abu Much A, et al. Vitamin D and rheumatoid arthritis: an ongoing mystery. Curr Opin Rheumatol. 2017;29:378-88.
  • 22. Song GG, Bae SC, Lee YH. Association between vitamin D intake and the risk of rheumatoid arthritis: a meta-analysis. Clin Rheumatol. 2012;31:1733–9.
  • 23. Raczkiewicz A, Kisiel B, Kulig M, Tłustochowicz W.Vitamin D status and its association with quality of life, physical activity, and disease activity in rheumatoid arthritis patients. J Clin Rheumatol. 2015;21:126-30.
  • 24. Elbassiony SR, Tawhid Z, Ahmad, HS, Sabry A. Serum 25-hydroxy vitamin D levels in Egyptian patients with rheumatoid arthritis: association with disease activity, functional disability and radiological damage. Egyptian Rheumatol. 2016;38:133–9.

Impact of vitamin D on rheumatoid arthritis: real or just patient’s perception?

Year 2018, Volume:3 Issue: 3, 127 - 131, 30.11.2018
https://doi.org/10.25000/acem.440559

Abstract





Aim: In this study, our aims were to identify
vitamin D levels in rheumatoid arthritis (RA) individuals as compared to
controls and the impact of vitamin D levels on both objective and subjective
assessments in RA patients.

Methods: The current study was a prospective
case-control study
conducted
on 108 RA patients and 50 age-gender matched healthy controls. We first
compared the levels of vitamin D among the RA patients and controls.
Demographic and clinical data, parameters of disease activity, inflammatory
markers, rheumatoid factor and anti-cyclic citrullinated peptide seropositivity
and radiological damage scores were recorded in RA patients. These patients
were also demanded to complete RA Quality of Life Questionnaire (RAQoL),
fatigue severity scale (FSS)  and Health
Assessment Questionnaire (HAQ).

Results: D vitamin levels in RA patients were
significantly lower than healthy controls (p=0.001). Vitamin D deficiency was
determined in 73% of the RA patients and 52% of the controls. Vitamin D
deficiency was not associated with disease activity (p=0.862). There was no
significant relationship among vitamin D levels and all subjective and
objective assessments (p>0.05 for all ).







Conclusion: Vitamin D deficiency was common in
RA participants than normal population. However, it was not shown that there
was a significant relationship between vitamin D levels and objective and
subjective assessments of disease, including disease activity, inflammatory markers,
rheumatoid factor and anti-cyclic citrullinated peptide seropositivity,
radiological damage scores, RAQoL, FSS and HAQ.

References

  • 1. Hong Q, Xu J, Xu S, Lian L, Zhang M, Ding C. Associations between serum 25-hydroxyvitamin D and disease activity, inflammatory cytokines and bone loss in patients with rheumatoid arthritis. Rheumatology (Oxford). 2014; 53:1994-2001.
  • 2. Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity. J Nat Sci Biol Med. 2018;9:54-8.
  • 3. Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential. Front Immun. 2016;7:697.
  • 4. Lee YH, Bae SC. Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: a meta-analysis. Clin Exp Rheumatol. 2016;34:827-33.
  • 5. Polasik K, Piotrowska E, Lipińska B, Witkowski JM, Bryl E, Tukaj S. Vitamin D status in patients with rheumatoid arthritis: a correlation analysis with disease activity and progression, as well as serum IL-6 levels. Acta Biochim Pol. 2017;64:667-70.
  • 6. Wong TH, Gupta ED, Radhakrishnan AK, Gun SC, Chembalingam G, Yeap SS. Effects of 25-hydroxyvitamin D and vitamin D-binding protein on bone mineral density and disease activity in Malaysian patients with rheumatoid arthritis. Int J Rheum Dis. 2018;21:992-1000.
  • 7. Baker JF, Baker DG, Toedter G, Shults J, Von Feldt JM, Leonard MB. Associations between vitamin D, disease activity, and clinical response to therapy in rheumatoid arthritis. Clin Exp Rheumatol. 2012;30:658-64.
  • 8. Higgins MJ, Mackie SL, Thalayasingam N, Bingham SJ, Hamilton J, Kelly CA. The effect of vitamin D levels on the assessment of disease activity in rheumatoid arthritis. Clin Rheumatol. 2013;32:863-7.
  • 9. van der Linden MP, Knevel R, Huizinga TW, van der Helm-van Mil AH. Classification of rheumatoid arthritis: Comparison of the 1987 American College of Rheumatology criteria and the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Arthritis Rheum. 2011;63:37–42.
  • 10. De Jong Z, van der Heijde D, McKenna S, Whalley D. Development and validation of a RA‐specific quality of life measure (RAQoL). Arthritis Rheum. 1995;38:175.
  • 11. Tijhuis GJ, de Jong Z, Zwinderman AH, Zuijderduin WM, Jansen LM, Hazes JM, et al. The validity of the Rheumatoid Arthritis Quality of Life (RAQoL) questionnaire. Rheumatology (Oxford). 2001 40:1112–9.
  • 12. Krupp LB. The fatigue severity scale. Application to patients with multiple sclerosis and systemic lupus erythematosus. Arch Neurol. 1989;46:1121–3.
  • 13. Bruce B, Fries J: The Stanford health assessment questionnaire (HAQ): a review of its history, issues, progress, and documentation. J Rheumatol. 2003;30:167-78.
  • 14. van der Heijde D. How to read radiographs according to the Sharp/van der Heijde method. J Rheumatol. 2000;27:2613.
  • 15. Hajjaj-Hassouni N, Mawani N, Allali F, Rkain H, Hassouni K, Hmamouchi I,et al. Evaluation of Vitamin D Status in Rheumatoid Arthritis and Its Association with Disease Activity across 15 Countries: “The COMORA Study.” Int J Rheumatol. 2017;2017:5491676.
  • 16. Chandrashekara S, Patted A. Role of vitamin D supplementation in improving disease activity in rheumatoid arthritis: An exploratory study. Int J Rheum Dis. 2017;20:825-31.
  • 17. Quintana-Duque MA, Caminos JE, Varela-Nariño A, Calvo-Paramo E, Yunis JJ, Iglesias-Gamarra A. The Role of 25-Hydroxyvitamin D as a Predictor of Clinical and Radiological Outcomes in Early Onset Rheumatoid Arthritis. J Clin Rheumatol. 2017;23:33-9.
  • 18. Fransen J, van Riel PL. The disease activity score and the EULAR response criteria. Clin Exp Rheumatol. 2005;23:93–9.
  • 19. Franco AS, Freitas TQ, Bernardo WM, Pereira RMR. Vitamin D supplementation and disease activity in patients with immune-mediated rheumatic diseases: A systematic review and meta-analysis. Medicine. 2017;96:e7024.
  • 20. Cantorna MT, Hayes CE, Deluca HF. 1,25-Dihydroxycholecalciferol inhibits the progression of arthritis in murine models of human arthritis. J Nutr. 1998;128:68–72.
  • 21. Bragazzi NL, Watad A, Neumann SG, Simon M, Brown SB, Abu Much A, et al. Vitamin D and rheumatoid arthritis: an ongoing mystery. Curr Opin Rheumatol. 2017;29:378-88.
  • 22. Song GG, Bae SC, Lee YH. Association between vitamin D intake and the risk of rheumatoid arthritis: a meta-analysis. Clin Rheumatol. 2012;31:1733–9.
  • 23. Raczkiewicz A, Kisiel B, Kulig M, Tłustochowicz W.Vitamin D status and its association with quality of life, physical activity, and disease activity in rheumatoid arthritis patients. J Clin Rheumatol. 2015;21:126-30.
  • 24. Elbassiony SR, Tawhid Z, Ahmad, HS, Sabry A. Serum 25-hydroxy vitamin D levels in Egyptian patients with rheumatoid arthritis: association with disease activity, functional disability and radiological damage. Egyptian Rheumatol. 2016;38:133–9.
There are 24 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Original Research
Authors

Aslı Çalışkan Uçkun 0000-0002-2492-4852

Fatma Gül Yurdakul 0000-0001-8630-9233

Ayşegül Kılıçarslan This is me 0000-0002-4690-8626

Bedriye Başkan This is me 0000-0002-2977-0071

Filiz Sivas 0000-0003-1705-9028

Semra Duran 0000-0003-0863-2443

Hatice Bodur

Publication Date November 30, 2018
Published in Issue Year 2018 Volume:3 Issue: 3

Cite

Vancouver Çalışkan Uçkun A, Yurdakul FG, Kılıçarslan A, Başkan B, Sivas F, Duran S, Bodur H. Impact of vitamin D on rheumatoid arthritis: real or just patient’s perception?. Arch Clin Exp Med. 2018;3(3):127-31.