Correlation between Vitamin D Deficiencyand Rheumatoid Arthritis Patients.

The main aim and objective of this study was to determine the prevalence of Vitamin D deficiency in patients with rheumatoid arthritis (RA) and compare the serum Vitamin D levels to healthy controls and also establish relationship between 25-hydroxyvitamin D (25(OH)D) with disease activity and disability. A cross sectional study was designed to include 50 RA patients (case) and 50 (controls), from Rajiv Gandhi Hospital & Research Center from duration 2012-2015. All patients had serum 25(OH) D measured in a laboratory and Vitamin D levels were analyzed in correlation with disease activity, functional impairment. The main objective of this study to determine Vitamin D level in Rheumatoid Arthritis (RA) patient and healthy controls and to estimate the prevalence of Vitamin D deficiency in patients in Rheumatoid Arthritis ( RA) as compared to healthy controls and to analyze the association between 25-hydroyvitamin D (25(OH) D)with disease activity. The study includes 50 RA patients (case) and 50 (controls), from Rajiv Gandhi Hospital & Research Center from duration 2012-2015.All enrolled patients had serum 25(OH) D measured in a laboratory under set conditions. The percentage of RA patients with vitamin D deficiency (25(OH) D level <20 ng/ml) was 33.5%, where as in control group percentage observed was (18.6 %). In RA patients, 25(OH) D levels were negatively correlated with the Health Assessment Questionnaire Disability Index, Disease Activity Score (DAS28), and Mobility Activities of daily living score. Significantly lower 25(OH) D values were found in patients not in disease remission or responding poorly to treatment, and with the highest Stein rocker functional state. It was also found that Body mass index (BMI) was good predictors of 25(OH) D values (P < 0.001). The association between disease activity or functional scores and 25(OH) D levels remained statistically significant even after adjusting 25(OH) D levels for both BMI. In RA patient’s vitamin D deficiency is quite common, disease activity and disability scores are inversely related to 25(OH) D levels. The study concluded Overweight RA patients, with high BMI and raised DAS score and disable RA patients has low titers of Vitamin D deficiency and the same could be a proposed cause for rapid bone loss in RA patients besides autoimmune factor. Based on the merits of results obtained this study may be a recommended guideline in management of RA patients, where it is proposed that Vitamin D supplementation should be included in Reverse pyramid regimen in management of RA patients and regular monitoring of Vitamin D levels every 6 months should be emphasized for PCP .