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Vitamin D, disease activity and comorbidities in early spondyloarthritis

1, 2, 3, 4, 5, 6, 7

 

  1. Rheumatology Dept., Paris Descartes Univ., APHP Cochin Hosp., INSERM (U1153), Paris, France; and Faculty of Medicine, Laboratory of Biostatistics Clinical Research and Epidemiology, Rheumatology Dept., Mohammed V Univ., El Ayachi Hosp., Rabat, Morocco.
  2. Rheumatology Department, Paris Descartes University, APHP Cochin Hospital, INSERM (U1153), Paris, France.
  3. Rheumatology Department, Paris Descartes University, APHP Cochin Hospital, INSERM (U1153), Paris, France.
  4. Rheumatology Department, Paris Descartes University, APHP Cochin Hospital, INSERM (U1153), Paris, France.
  5. Biology Department, Paris Descartes University, APHP Cochin Hospital, Paris, France.
  6. Department of Rheumatology, Montpellier I University, Lapeyronie Hospital, UMR 5535, EA2415, Montpellier, France.
  7. Rheumatology Department, Paris Descartes University, APHP Cochin Hospital, INSERM (U1153), Paris, France.

CER8752
2016 Vol.34, N°3
PI 0396, PF 0403
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PMID: 27050724 [PubMed]

Received: 02/07/2015
Accepted : 16/09/2015
In Press: 05/04/2016
Published: 30/05/2016

Abstract

OBJECTIVES:
To assess the vitamin D status in patients presenting inflammatory back pain suggestive of axial spondyloarthritis and to assess the relationship between vitamin D status and disease activity/severity; comorbidities at baseline and during the first two years of follow-up.
METHODS:
DESIR is a prospective, multicentre, observational study. Vitamin D deficiency was defined as <50 nmol/L and severe deficiency less than 25 nmol/L. Clinical variables were collected at each six month interval visits during the two-year follow-up.
RESULTS:
A total of 700 patients were analysed. The mean vitamin D was 54.2±28.7 nmol/L. Severe deficiency were observed in 11.7% versus 5% in the DESIR cohort versus the French population respectively. In the DESIR cohort, after adjusting for season and ethnicity, vitamin D deficiency remained significantly associated with presence of radiological sacroiliitis, higher ASDAS score and elevated BASDAI. Such association was also found between vitamin D deficiency and the mean value of disease activity/severity parameters during the two-year follow-up. Otherwise, vitamin D deficiency was significantly associated with the presence of baseline abdominal obesity (OR=1.65 [1.05–2.61], p=0.03), low HDL (OR=1.71 [1.14–2.55], p=0.01) and presence of metabolic syndrome (OR=2.20 [1.04–4.64], p=0.03) at baseline.
CONCLUSIONS:
We found a higher percentage of patients with severe vitamin D deficiency in early axial spondyloarthritis. Vitamin D deficiency was associated with higher disease activity and severity and presence of metabolic syndrome. Further longitudinal studies are required to evaluate the interest of vitamin D supplementation on the long-term outcome of the disease.

Rheumatology Article