Relationship between serum vitamin D levels and disease activation in patients with rheumatoid arthritis, ankylosing spondylitis and scleroderma

Relationship between serum vitamin D levels and disease activation in patients with rheumatoid arthritis, ankylosing spondylitis and sclerodermaPurpose: A few studies are available regarding that low levels of 25 (OH) vitamin D3 is associated with activation of autoimmune disease such as rheumatoid arthritis (RA), Behçet disease, SLE, Type 1 Diabetes, multiple sclerosis (MS) and increase risk of occurrence of these diseases. However there is no clear conclusion, debates have been continued.Relationship between vitamin D levels and activation of disease in patients with RA, scleroderma, and ankylosing spondylitis was investigated in this study.Material and method: Forty-nine patients with rheumatoid arthritis, 43 patients with ankylosing spondylitis, 62 patients with scleroderma were included into this study.52 healthy participants without rheumatic and metabolic bone diseases in control grouphad been included to the study. Participants with rheumatic and metabolic bone diseases were not included to the control group. Activation was assessed by DAS28 in RA , BASDAI in AS and Valentini criteria in Scleroderma .Activity of disease were also grouped as low, medium and high activity in patients with RA; low and high activity in patients with AS; remission and active disease in patients with scleroderma. 25 (OH) Vitamin D3 levels of all participant were measured by HPLC ( high-pressure liquid chromatography) method.Study participants were grouped as; Vitamin D deficiency if serum 25 (OH) Vitamin D level is below 10 ng/ml, vitamin D insufficient if Vitamin D levels are within wange of 10-30 ng/ml , sufficient if Vitamin D level is above 30 ng/ml. ESR, CRP, routine biochemical tests were evaluated in all patients. Besides ANA, Anti-SCL70, ACA were ordered in sclerodermapulmonary artery pressure was measured by echocardiography.Patients also undergone HRCT and upper GI endoscopy as needed.Results: 26,5% of patient with RA had Vitamin D deficiency and 63.3 % of them had vitamin D insufficiency; 50 % of patient with scleroderma had vitamin D deficiency and 46.8 % of them had vitamin D insufficiency; 14 of patient with AS had Vitamin D deficiency and 60.4% of them had vitamin D insufficiency; 7.7% of control group had Vitamin D deficiency and 88,5% of them had vitamin D insufficiency. When the patient with AS and RA were compared for Mean Vitamin D levels, there were no significant difference from the control group . Although there was a nonsignificant inverse correlation between DAS 28 and vitamin D levels, (r= -0,246, p=0,088). Mean Vitamin D levels of patients with scleroderma were significantly lower than the control group (p=0.003). Vitamin D levels of patients who has active scleroderma were found significantly lower than patients who has remission scleroderma (p<0,0001) . Besides,