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Effects of 25‐hydroxyvitamin D and vitamin D‐binding protein on bone mineral density and disease activity in Malaysian patients with rheumatoid arthritis
Author(s) -
Wong Tze Hao,
Gupta Esha Das,
Radhakrishnan Ammu K.,
Gun Suk Chyn,
Chembalingam Gandhi,
Yeap Swan Sim
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13048
Subject(s) - medicine , rheumatoid arthritis , vitamin d and neurology , bone mineral , body mass index , vitamin d binding protein , vitamin d deficiency , endocrinology , gastroenterology , osteoporosis
Aim Vitamin D3 [25( OH )D] has been shown to be important in bone health and can influence rheumatoid arthritis ( RA ) disease activity. Vitamin D‐binding protein ( VDBP ) levels vary with race and may modulate ‘bioavailable’ levels of 25( OH )D. The aim of this study was to explore the relationships between 25( OH )D, VDBP and clinical factors on bone mineral density ( BMD ) in a group of multi‐ethnic Malaysian RA patients and healthy controls. Methods A cross‐sectional study of 77 female RA patients and 29 controls was performed. Serum 25( OH )D was measured using the Elecsys ® Vitamin D total assay. Serum VDBP was measured using a Quantikine ® enzyme‐linked immunosorbent assay kit. BMD was assessed using dual‐energy X‐ray absorptiometry ( DXA ). Results Overall, mean 25( OH )D levels were 42.66 ± 21.75 nmol/L with no significant difference between RA patients and controls. 25( OH )D levels were significantly higher in Chinese, compared to Malay/Indian subjects. In RA patients, menopausal status and body mass index ( BMI ) were significantly associated with BMD but not 25( OH )D or RA Disease Activity Score of 28 joints ( DAS 28). There was no significant correlation between 25( OH )D and DAS 28, even after correction for menopausal status and BMI . VDBP levels were not significantly different between the races and did not significantly correlate with BMD , 25( OH )D overall, or DAS 28 in RA patients. Conclusions In Malaysian RA patients, menopausal status and BMI were more important influences on BMD than 25( OH )D or RA disease activity. The utility of measuring VDBP levels in this population remains uncertain.