Vitamin D Metabolism and Pain in Rheumatoid Arthritis

• Autor(a) principal: Andrade,Filipe
• Data de Publicação: 2018
• Outros Autores: Moreira,Albina, Môço,Rui, Alves,Rosário, Vasconcelos,Alexandre, Eiras,Eduardo, Soares,Carlos, Ferreira,Anabela
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-671X2018000100009
• topic: Arthritis; Rheumatoid; Pain; Parathyroid Hormone; Vitamin D; Vitamin D Deficiency

Introduction: Vitamin D deficiency has been linked to increased susceptibility to the development of rheumatoid arthritis and with disease activity. The objective of this study was to evaluate vitamin D status in patients with RA and to assess the relationship between vitamin D levels and pain. Methods: In a cohort of 45 patients with RA, 25-hydroxyvitamin D3 [25(OH)D3] levels, parathyroid hormone, C-reactive protein (CRP) and albumin levels were measured. Disease activity was evaluated by calculating the 28-joint Disease Activity Score (DAS28). Results: Forty five patients were included in the study. Thirty one patients were in remission, 11 patients had painful joints and the median VAS pain score was 30. Out of the 45 patients, 41 had vitamin D levels below 30 ng/mL. Levels of 25(OH)D3 were not found to be correlated to the DAS28 score (p = 0.59), the VAS pain score (p = 0.55) or CRP (p = 0.16). Parathyroid hormone levels were positively correlated to CRP (p = 0.01). Conclusion: In our study, it appears that vitamin D deficiency is highly prevalent in patients with RA but it is not linked to disease severity or pain experienced in RA. PTH levels are related to CRP and but not to the number of painful joints or VAS pain score. This relationship may reflect uncontrolled disease or be a reflection of physiological vitamin deficiency. Vitamin D supplementation may be needed both for the prevention of osteoporosis as well as for better disease control in patients with RA and low levels of vitamin D and high CRP.