Effects of 25‐hydroxyvitamin D and vitamin D‐binding protein on bone mineral density and disease activity in Malaysian patients with rheumatoid arthritis

Wong, Tze Hao; Gupta, Ekta; Radhakrishnan, Ammu Kutty; Gun, Suk Chyn; Chembalingam, Gandhi; Yeap, Swan Sim

doi:10.1111/1756-185x.13048

Cited by 11 publications

(13 citation statements)

References 48 publications

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“…We compared ethnicity distribution in relation to vitamin D deficiency in RA patients and found that the concentrations of serum 25(OH)D among Malays and Indians were significantly lower compared to the Chinese. This result is consistent with the findings in our healthy controls and few other studies done in the Malaysian population as well as in the neighboring country, Singapore . The higher melanin content inhibiting the skin synthesis of vitamin D is the likely reason for the more prevalent vitamin D deficiency in Malays and Indians who have darker skin compared to the Chinese.…”

Section: Discussionsupporting

confidence: 93%

“…In contrast to our hypothesis, we observed no association between vitamin D deficiency and disease activity in RA subjects. These findings were similar to the previous Malaysian study as well as to the Japanese and Thai studies . Similar findings were also observed in Western populations .…”

Section: Discussionsupporting

confidence: 92%

“…Certain studies conducted in Europe reported there was no significant difference in 25(OH)D levels between RA subjects and controls, while other studies which reported that RA patients had significantly lower levels of 25(OH)D compared to controls were from Japan, China and India . Our study found that RA patients had low mean 25(OH)D levels but were higher than the healthy controls with this similar finding also observed in another recent Malaysian study . This could be explained by the smaller sample size of the healthy controls and the non‐ethnicity matched controls where the Chinese ratio to Malays and Indians was 1:4 in our healthy controls.…”

Section: Discussionsupporting

confidence: 82%

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Effects of vitamin D on disease activity and serum interleukin‐6 in rheumatoid arthritis

Gopal

Thevarajah

et al. 2019

Int J of Rheum Dis

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Aim Vitamin D3 or 25(OH)D3 may have a potential role in rheumatoid arthritis (RA) pathogenesis by inhibiting the expression of pro‐inflammatory cytokines including interleukin‐6 (IL‐6). The aim of this study is to determine the clinical factors of vitamin D deficiency in multi‐ethnic Malaysian RA patients and its association with disease activity, functional disability and serum IL‐6 levels. Method One hundred RA patients and 50 healthy controls, sex‐ and age‐matched, were recruited. Disease Activity Score of 28 joints and Health Assessment Questionnaire scores were assessed. Baseline serum 25(OH)D3 and IL‐6 were measured in all subjects. RA patients who were vitamin D deficient were given loading doses of vitamin D3 and repeated assessments were done. Results Vitamin D deficiency (<50 nmol/L) was found in 63% of RA patients and 76% of healthy controls. Chinese RA patients and healthy controls had significantly more sufficient 25(OH)D3 levels compared to Malays and Indians (P < 0.001). Serum 25(OH)D3 level was still negatively associated with body mass index in RA patients (P = 0.002) after adjustment for potential confounding variables. No significant association was seen between 25(OH)D3 levels and disease activity or serum IL‐6 levels in both pre‐ and post‐treatment groups. A negative association was observed between serum 25(OH)D3 and functional disability, including a 33% improvement post‐treatment (mean ± SD: 0.30 ± 0.46 to 0.20 ± 0.18). Conclusion Vitamin D deficiency is prevalent in Malaysian RA patients. This study suggests that vitamin D is not associated with disease activity or serum IL‐6 levels but it may have a role in functional disability in RA patients.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 82%

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Effects of vitamin D on disease activity and serum interleukin‐6 in rheumatoid arthritis

Gopal

Thevarajah

et al. 2019

Int J of Rheum Dis

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“…24 In a more recent study of female rheumatoid arthritis patients, Chinese patients had lower FN and total hip BMDs compared to Malay and Indian patients, with no difference in LS BMD. 25 Thus it would seem that in multi-ethnic populations in SEA, the Chinese will have a lower hip BMD compared to Malays and Indians with no difference in LS BMD, suggesting the need for ethnicity-based normative data for BMD.…”

Section: Bmd Differences Within Individual Se Asian Countriesmentioning

confidence: 99%

Harmonization of commercial assays for PINP; the way forward

et al. 2020

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Osteoporosis (OP) is a condition where there is low bone density and microarchitectural deterioration which can predispose to fragility fractures. There is a wealth of literature on OP from the developed countries, but less so from Asia. This review will explore the field of OP research in SouthEast Asia with regard to the epidemiology, the diagnosis of OP and the role of laboratory tests in the management of OP, with emphasis on 25-dihydroxyvitamin D and bone turnover markers.

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“…Another interesting issue is whether vitamin D has an inverse relation with RA activity. The evidence from various studies concerning the link between serum vitamin D concentration and disease activity is inconsistent [5][6][7]. Some studies also revealed that the impact of inadequate vitamin D levels on disease activity in the RA individuals was associated with more subjective variables (eg, Visual Analog Scale (VAS) pain, tender joint count (TJC)) than a real objective immunomodulatory effect [8].…”

Section: Introductionmentioning

confidence: 99%

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

Uçkun

Yurdakul

Kılıçarslan

et al. 2018

Archives of Clinical and Experimental Medicine

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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 agegender 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.

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Effects of 25‐hydroxyvitamin D and vitamin D‐binding protein on bone mineral density and disease activity in Malaysian patients with rheumatoid arthritis

Abstract: In Malaysian RA patients, menopausal status and BMI were more important influences on BMD than 25(OH)D or RA disease activity. The utility of measuring VDBP levels in this population remains uncertain.

Cited by 11 publications

References 48 publications

Effects of vitamin D on disease activity and serum interleukin‐6 in rheumatoid arthritis

Effects of vitamin D on disease activity and serum interleukin‐6 in rheumatoid arthritis

Harmonization of commercial assays for PINP; the way forward

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

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