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The D‐vitamin metabolite 1,25( OH ) 2 D in serum is associated with disease activity and Anti‐Citrullinated Protein Antibodies in active and treatment naïve, early Rheumatoid Arthritis Patients
Author(s) -
Herly Mette,
StengaardPedersen Kristian,
Vestergaard Peter,
Østergaard Mikkel,
Junker Peter,
Hetland Merete L.,
HørslevPetersen Kim,
Ellingsen Torkell
Publication year - 2018
Publication title -
scandinavian journal of immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.934
H-Index - 88
eISSN - 1365-3083
pISSN - 0300-9475
DOI - 10.1111/sji.12704
Subject(s) - metabolite , antibody , disease , vitamin d and neurology , vitamin , medicine , chemistry , immunology , pharmacology , microbiology and biotechnology , biology , biochemistry
Rationale Sufficient levels of vitamin D seem to be essential for proper immune function, and low levels might be associated to disease activity in Rheumatoid Arthritis ( RA ). Most studies investigate only 25 OHD and not the physiologically active vitamin D metabolite, 1,25( OH ) 2 D. Objective To investigate associations between serum level of vitamin D metabolites and disease activity parameters in 160 inflammatory active and treatment naïve early RA patients. Serum level of vitamin D metabolites (25 OHD 2 , 25 OHD 3 and 1,25( OH ) 2 D) was measured by isotope dilution mass spectrometry and radio‐immunoassays at baseline. Disease characteristics were gender, number of tender joints, number of swollen joints, DAS 28‐ CRP , HAQ , VAS ‐scores, CRP , erosive status (Total Sharp Score; TSS ), ACPA and IgM‐ RF ‐status. Associations were evaluated using Spearman's and Wilcoxon rank‐sum tests. The study was registered in clinical trials; trial registration number: NCT 00209859. Findings Statistically significant inverse associations were found between the active metabolite 1,25( OH ) 2 D and DAS 28‐ CRP ( P = 0.004, rho = −0.23), HAQ ( P = 0.005, rho = −0.22), CRP ( P = 0.001, rho = −0.25), VAS patient‐pain ( P = 0.008, rho = −0.21), and a positive association was found to ACPA ‐status ( P = 0.04). Conclusion The vitamin D metabolite 1,25( OH ) 2 D was inversely associated with disease activity and positively associated with ACPA in treatment naïve and inflammatory active early RA . The results indicate that in RA , both the degree of inflammatory activity, and the diagnostic sensitivity and specificity might affect—or might be affected by the level of vitamin 1,25( OH ) 2 D.