Low vitamin D level is not associated with increased incidence of rheumatoid arthritis

Abstract

To evaluate the association of vitamin D level with incident rheumatoid arthritis (RA) in a patient population using electronic health records (EHR). Case-control study with data extracted from EHR from 1/1/2001 to 12/31/2012 in the Geisinger Health System (GHS). Incident RA was defined as International Classification of Disease-9 code 714.0 twice by a GHS rheumatologist. Patients were identified at time of RA diagnoses and were matched 1:5 for age and gender with non-RA controls. Vitamin D levels were identified and extracted prior to RA diagnosis. The subjects were followed retrospectively with regard to their vitamin D levels; the most recent value of vitamin D prior to the RA diagnosis was used in the analysis. Vitamin D levels were treated both as continuous and categorical with two different cutoff values, 30 and 20 ng/ml. The association between vitamin D and RA was presented as the odds ratios with 95 % confidence intervals (OR, 95 % CI) from a conditional logistic regression model adjusting for obesity and smoking status. A total of 270 patients with incident RA and 1,341 matched controls were identified. The RA patients were 83.3 % female with median age at RA diagnosis of 62 years. The adjusted OR (95 % CI) for the association of vitamin D levels with incident RA compared with controls was 1.00 (0.99, 1.01), 0.98 (0.75, 1.29) and 1.12 (0.80, 1.57) for continuous, <30 and <20 ng/ml vitamin D levels, respectively. Subgroup analysis according to gender or rheumatoid factor positivity yielded similar results. In this patient population, vitamin D levels were not associated with the development of RA.

The association between vitamin D concentration and pain: a systematic review and meta-analysis

“…According to the Newcastle–Ottawa scale, sixty-two of the eighty-one observational studies were very good or good quality ( 33 – 35 , 37 , 39 – 43 , 45 , 48 , 49 , 51 , 54 – 57 , 59 , 60 , 62 , 64 – 70 , 72 – 74 , 76 – 82 , 84 , 86 – 100 , 102 – 108 ) , sixteen were satisfactory ( 31 , 44 , 46 , 47 , 50 , 52 , 53 , 58 , 61 , 63 , 71 , 75 , 83 , 85 , 101 ) and the remaining three were unsatisfactory ( 32 , 36 , 38 ) . Specifically, the quality for cross-sectional studies was good for twelve, satisfactory for four and unsatisfactory for three; for case–control studies, nine were very good, thirty-five were good and twelve were satisfactory; and for cohort studies, three were very good and three good.…”

“…[54][55][56][57]59,61,62,[65][66][67][68][69][74][75][76][77][79][80][81][82][83][87][88][89][91][92][93][94][95][96][97][98][99]103,106,107) …”

Vitamin D as an Immunomodulator: Risks with Deficiencies and Benefits of Supplementation

“…The association between vitamin D deficiency and RA has remained difficult to establish. Some studies find no correlation between vitamin D deficiency and the risk of developing RA [ 80 , 81 , 82 , 83 ], while others have found that vitamin D deficiency increases risk of RA [ 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 ]. Some, but not all, of these studies have also found an inverse relationship between serum vitamin D levels and disease activity [ 86 , 87 , 89 , 91 , 92 ]; other studies looking at pools of RA patients have similarly shown an inverse relationship between disease severity and vitamin D levels [ 83 , 93 , 94 ].…”

Association between baseline vitamin D metabolite levels and long-term cardiovascular events in patients with rheumatoid arthritis from the CIMESTRA trial: protocol for a cohort study with patient-record evaluated outcomes

“… 10–12 Some epidemiological studies have shown significant associations between low vitamin D and the prevalence of autoimmune disease, including RA, 13 whereas recent studies and meta-analyses question this association. 14 15 …”