The vitamin D status in ankylosing spondylitis in relation to intestinal inflammation, disease activity, and bone health: a cross-sectional study

Klingberg, Eva; Oleröd, Göran; Hammarsten, Ola; Forsblad-d’Elia, Helena

doi:10.1007/s00198-016-3489-7

Cited by 20 publications

(20 citation statements)

References 40 publications

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“…While several studies had shown the aggravating effect of vitamin D's deficiency in the activity markers of AS disease [61][62][63][64] , other studies have not found any correlation [65][66][67] . Although, there is evidence for increased risk of AS in people with deficiency of vitamin D [68][69][70] further studies are required to clarify the causal relationship between the deficiency of vitamin D and activity of AS disease.…”

Section: Vitamin D and Severity Of Asmentioning

confidence: 91%

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Kalogeropoulou¹

2017

JRPMS

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Section: Vitamin D and Severity Of Asmentioning

confidence: 91%

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Kalogeropoulou¹

2017

JRPMS

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“…Serum levels of 25(OH)D have been determined in AS patients and compared with healthy subjects in a number of cross-sectional studies (Table 1) [18, 19, 21–28]. The Swedish study by Klingberg et al found no difference in serum 25(OH)D of 203 AS patients compared with 120 healthy subjects in the late winter season [21].…”

Section: Epidemiology Of Vitamin D Deficiency In “As”mentioning

confidence: 99%

“…The Swedish study by Klingberg et al found no difference in serum 25(OH)D of 203 AS patients compared with 120 healthy subjects in the late winter season [21]. Nevertheless, there were significantly more users of vitamin D supplements in the AS group compared with healthy controls, what may have masked any difference.…”

Section: Epidemiology Of Vitamin D Deficiency In “As”mentioning

confidence: 99%

“…While some studies have demonstrated a significant negative correlation between AS disease activity markers and vitamin D deficiency [18, 19, 22, 25, 27], other studies have not found any correlation [21, 22, 24, 36]. Of note, disease activity markers have extensively been assessed in all those studies, from less sensitive and specific disease activity markers including CRP and erythrocyte sedimentation rate (ESR) to more specific markers, that is, Bath AS Disease Activity Index (BASDAI) and Bath AS Functional Index (BASFI).…”

Section: Mechanistic Link Between Low Vitamin D Status and “As”mentioning

confidence: 99%

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Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Essouma

Noubiap

2017

International Journal of Inflammation

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Beyond its role in calcium and phosphorus metabolism for healthy bone mineralization, there is increasing awareness for vitamin D contribution in modulation of immune reactions. Given that ankylosing spondylitis (AS) is a chronic inflammatory disease involving excess immune/inflammatory activity and posing great therapeutic challenges, it is conceivable to claim that vitamin D treatment may be a safe and effective treatment to influence or modify the primary disease and its related comorbidities. Nevertheless, consistent body of research supporting this hypothesis is still lacking. In this paper, we examine whether systematic screening and treatment for vitamin D deficiency are feasible at present. We will review the immunomodulatory role of vitamin D and its contribution in initiation and progression of AS, as well as how they would determine the occurrence of comorbid conditions. Our conclusion is that despite the overwhelmed interest about vitamin D treatment in AS patients, systematic screening and treatment for vitamin D deficiency of all AS patients are not feasible as yet. This stresses the need for further extensive well-designed research to prove vitamin D efficacy in AS beyond bone protection. And if utility is proven, personalized treatment regimes, duration of treatment, and threshold values for vitamin D should be provided.

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“…While Vitamin D deficiency has been found to occur with greater prevalence in AS in some studies, other studies have failed to show a significant difference from controls [34–36]. In a recent study by Klingberg et al, there was no correlation with 25-OH-Vitamin D levels and BMD or vertebral fractures in patients with AS [36].…”

Section: Treatmentmentioning

confidence: 99%

Osteoporosis Management in Ankylosing Spondylitis

Hinze

Louie

2016

Curr Treat Options in Rheum

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OPINION STATEMENT Low bone mineral density (BMD) is increasingly recognized as a common comorbid condition in ankylosing spondylitis (AS). As low BMD increases fracture risk, it is important to identify and treat low BMD in patients with AS who have been shown to be at increased risk for fractures above the population normal. Since low BMD occurs early in disease, we screen during the first year of diagnosis with dual energy x-ray absorptiometry (DXA). If patients are found to have osteoporosis by T-score of less than −2.5 or if their Z-score on DXA is more than two standard deviations below the mean, we initiate therapy with bisphosphonates in males and in females who are not planning any future pregnancies. While reduction in fracture risk with bisphosphonate therapy has not been clearly defined in patients with AS, reduction in vertebral and hip fractures has been well established in primary osteoporosis and thus it is our first line treatment. If there are contraindications to the use of bisphosphonates in the treatment of low BMD, we will consider the use of denosumab. If the patient is not receiving a TNF-alpha inhibitor (TNFi) and has active disease, we also favor early initiation of TNFi due to their positive effects on BMD though the outcome on reduction in vertebral fractures remains unclear. We counsel all patients regarding the importance of adequate intake of vitamin D and calcium per the Institute of Medicine guidelines. All patients should be encouraged to participate in weight-bearing activities with a focus on core strength and gait training.

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The vitamin D status in ankylosing spondylitis in relation to intestinal inflammation, disease activity, and bone health: a cross-sectional study

Cited by 20 publications

References 40 publications

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Nutritional aspects and vitamin D supplementation in ankylosing spondylitis

Are Systematic Screening for Vitamin D Deficiency and Vitamin D Supplementation Currently Feasible for Ankylosing Spondylitis Patients?

Osteoporosis Management in Ankylosing Spondylitis

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