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Clin Exp Rheumatol. 2016 May-Jun;34(3):396-403. Epub 2016 Apr 5.

Vitamin D, disease activity and comorbidities in early spondyloarthritis.

Author information

1
Rheumatology Dept., Paris Descartes Univ., APHP Cochin Hosp., INSERM (U1153), Paris, France; and Faculty of Medicine, Laboratory of Biostatistics Clinical Research and Epidemiology, Rheumatology Dept., Mohammed V Univ., El Ayachi Hosp., Rabat, Morocco.
2
Rheumatology Department, Paris Descartes University, APHP Cochin Hospital, INSERM (U1153), Paris, France.
3
Biology Department, Paris Descartes University, APHP Cochin Hospital, Paris, France.
4
Department of Rheumatology, Montpellier I University, Lapeyronie Hospital, UMR 5535, EA2415, Montpellier, France.

Abstract

OBJECTIVES:

To assess the vitamin D status in patients presenting inflammatory back pain suggestive of axial spondyloarthritis and to assess the relationship between vitamin D status and disease activity/severity; comorbidities at baseline and during the first two years of follow-up.

METHODS:

DESIR is a prospective, multicentre, observational study. Vitamin D deficiency was defined as <50 nmol/L and severe deficiency less than 25 nmol/L. Clinical variables were collected at each six month interval visits during the two-year follow-up.

RESULTS:

A total of 700 patients were analysed. The mean vitamin D was 54.2±28.7 nmol/L. Severe deficiency were observed in 11.7% versus 5% in the DESIR cohort versus the French population respectively. In the DESIR cohort, after adjusting for season and ethnicity, vitamin D deficiency remained significantly associated with presence of radiological sacroiliitis, higher ASDAS score and elevated BASDAI. Such association was also found between vitamin D deficiency and the mean value of disease activity/severity parameters during the two-year follow-up. Otherwise, vitamin D deficiency was significantly associated with the presence of baseline abdominal obesity (OR=1.65 [1.05-2.61], p=0.03), low HDL (OR=1.71 [1.14-2.55], p=0.01) and presence of metabolic syndrome (OR=2.20 [1.04-4.64], p=0.03) at baseline.

CONCLUSIONS:

We found a higher percentage of patients with severe vitamin D deficiency in early axial spondyloarthritis. Vitamin D deficiency was associated with higher disease activity and severity and presence of metabolic syndrome. Further longitudinal studies are required to evaluate the interest of vitamin D supplementation on the long-term outcome of the disease.

PMID:
27050724
[Indexed for MEDLINE]

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