Association of vitamin D with cardiometabolic risk factors in rheumatoid arthritis

Abstract

Objectives Individuals with rheumatoid arthritis (RA) are at a greater risk for cardiovascular disease (CVD). Vitamin D deficiency is a potential risk factor for CVD and metabolic syndrome. Since patients with RA have a high prevalence of vitamin D deficiency, we investigated the association of vitamin D levels with cardiometabolic risk factors in a cohort of RA patients with no prior history of CVD. Methods Serum 25(OH)D levels were measured among RA patients enrolled in a cohort study of subclinical CVD. The cross-sectional associations of 25(OH)D level with traditional CVD risk factors, such as insulin resistance [estimated using the Homeostatic Model Assessment (HOMA)], adiopokines, markers of systemic inflammation and endothelial activation were explored, adjusting for pertinent sociodemographic, lifestyle, and RA characteristics. Results Among 179 RA patients, 73 (41%) had a 25(OH)D level <30ng/mL. Only 23 patients (13%) had a 25(OH)D level ≥45ng/mL. After adjusting for demographics and BMI, 25(OH)D remained significantly associated with HDL and inversely associated with HOMA-IR, fibrinogen, E-selectin, and s-ICAM. Significant associations with HDL, E-selectin, and s-ICAM were maintained after adjusting for DAS28 and autoantibody status. These associations were similar between groups subdivided by gender, ethnicity, body mass index, DAS28 level and autoantibody status. Conclusions These data suggest that vitamin D deficiency is common in RA and may be independently associated with several cardiometabolic intermediates in this population.

High-Sensitivity CRP is Associated with Serum 25-Hydroxyvitamin D Levels, but is not Affected by 5-Year Supplementation with Cholecalciferol

“…The relationship between serum 25 (OH) D concentrations and CRP (or hs-CRP) has been investigated in several studies, with inconsistent results [22][23][24]. We have therefore aimed to investigate the association between serum 25(OH)D concentration and hs-CRP based on both an observational study (the sixth Tromsø Study) and a 5-year interventional study (Tromsø vitamin D and T2DM trial: vitamin D vs. placebo in subjects with prediabetes).…”

Correlation between Vitamin D Deficiencyand Rheumatoid Arthritis Patients.

“…Given the increased risk for the development of cardiovascular disease in RA, Haque and colleagues further investigated the matter and found an association of vitamin D deficiency with cardio metabolic risk factors. 49,50 Vitamin D is responsible for immunologic tolerance 54 Thus, vitamin D deficiency may induce the development of autoimmune diseases, such as RA. Vitamin D has immunomodulatory properties, acting on the immune system both in an endocrine and in a paracrine manner 55 It appears to regulate the immune response by a variety of mechanisms, such as decreasing antigen presentation 56 , inhibiting the proinflammatory T helper type 1 profile and inducing regulatory T cells 57 1,25(OH) 2 D 3 suppresses proliferation and immunoglobulin production and retards differentiation of B-cell precursors into plasma cells 58 These data support a role for vitamin D deficiency in the development and progression of autoimmune inflammatory conditions in general, and in particular RA.…”

“…Clinical measures of disease related functional impairment included Health Assessment Questionnaire Disability Index (HAQ), Steinbrocker functional state and the mobility activities of daily living (ADL) [48][49][50] RA specific treatment were collected and included in drug history.…”

“…A cross sectional study was designed to include 50 RA patients (case) and 50 33.5%, where as in control group percentage observed was (18.6 %). In RA patients, 25(OH) D levels were negatively correlated with the Health Assessment Questionnaire Disability Index, Disease Activity Score (DAS28), and Mobility Activities of daily living score.…”

Association between insulin resistance and inflammatory cytokines among obese Saudi type 2 diabetic with vitamin D deficiency

“…Hotamisligil and colleagues were the first who stated the first link between obesity, inflammation and insulin action (21). The relations between 25(OH)D concentrations and inflammatory markers have been investigated in several studies, with most of these studies based on small samples or specific patient groups (22,23).…”