Vitamin D Metabolism and Pain in Rheumatoid Arthritis
DOI:
https://doi.org/10.24950/rspmi/original/184/1/2018Keywords:
Arthritis, Rheumatoid, Pain, Parathyroid Hormone, Vitamin D, Vitamin D DeficiencyAbstract
Introduction: Vitamin D deficiency has been linked to increased susceptibility to the development of rheumatoid arthritis and with disease activity. The objective of this study
was to evaluate vitamin D status in patients with RA and to
assess the relationship between vitamin D levels and pain.
Methods: In a cohort of 45 patients with RA, 25-hydroxyvitamin D3 [25(OH)D3] levels, parathyroid hormone, C-reactive
protein (CRP) and albumin levels were measured. Disease
activity was evaluated by calculating the 28-joint Disease Activity Score (DAS28).
Results: Forty five patients were included in the study. Thirty
one patients were in remission, 11 patients had painful joints
and the median VAS pain score was 30. Out of the 45 patients, 41 had vitamin D levels below 30 ng/mL. Levels of
25(OH)D3 were not found to be correlated to the DAS28
score (p = 0.59), the VAS pain score (p = 0.55) or CRP (p =
0.16). Parathyroid hormone levels were positively correlated
to CRP (p = 0.01).
Conclusion: In our study, it appears that vitamin D deficiency
is highly prevalent in patients with RA but it is not linked to
disease severity or pain experienced in RA. PTH levels are
related to CRP and but not to the number of painful joints
or VAS pain score. This relationship may reflect uncontrolled
disease or be a reflection of physiological vitamin deficiency.
Vitamin D supplementation may be needed both for the prevention of osteoporosis as well as for better disease control
in patients with RA and low levels of vitamin D and high CRP
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