University of Nebraska Medical Center, Nebraska Arthritis Outcomes Research Center (NAORC), Omaha Veterans Affairs Medical Center, Omaha, Nebraska 68198-6270, USA.
J Rheumatol. 2010 Feb;37(2):275-81. doi: 10.3899/jrheum.090705. Epub 2009 Dec 23.
To examine the prevalence of vitamin D insufficiency and the associations of vitamin D concentration with disease status in African Americans with rheumatoid arthritis (RA).
Study participants (n = 266) were enrolled in the Consortium for the Longitudinal Evaluation of African Americans with Early RA (CLEAR) Registry. The vitamin 25(OH)-D was measured on baseline plasma, and associations of 25(OH)-D with disease status (baseline and at 3 years' disease duration) were examined using univariate and multivariate regression.
The prevalence of 25(OH)-D insufficiency (<or= 37.5 nmol/l or 15 ng/ml) was 50%, with the highest prevalence in winter. In unadjusted analyses, vitamin D concentrations were inversely associated with baseline pain (p = 0.04), swollen joints (p = 0.04), and Disease Activity Score (DAS28, p = 0.05) but not with measures at 3 years' disease duration. There were no multivariate associations of 25(OH)-D with any disease measures at baseline or at 3 years, with the exception of a positive borderline association with rheumatoid factor positivity at enrollment (p = 0.05).
Vitamin D insufficiency is common in African Americans with recent-onset RA. Unadjusted associations of circulating vitamin D with baseline pain, swollen joints, and DAS28 were explained by differences in season, age, and gender and were not significant in multivariate analyses. In contrast to reports of Northern Europeans with early inflammatory arthritis, there are not strong associations of 25(OH)-D concentration with symptoms or disease severity in African Americans with RA.
研究非裔美国人类风湿关节炎（RA）患者维生素 D 不足的流行情况，以及维生素 D 浓度与疾病状态的关系。
研究参与者（n=266）参加了纵向评估非裔美国人早期 RA（CLEAR）登记处的联合会。在基线血浆中测量维生素 25（OH）-D，并使用单变量和多变量回归检查 25（OH）-D 与疾病状态（基线和 3 年疾病持续时间）的相关性。
25（OH）-D 不足（<或=37.5 nmol/l 或 15 ng/ml）的患病率为 50%，冬季患病率最高。在未调整的分析中，维生素 D 浓度与基线疼痛（p=0.04）、肿胀关节（p=0.04）和疾病活动评分（DAS28，p=0.05）呈负相关，但与 3 年疾病持续时间的测量值无关。25（OH）-D 与基线或 3 年时的任何疾病指标均无多变量相关性，除了与入组时类风湿因子阳性的正边缘关联（p=0.05）外。
非裔美国人新诊断 RA 患者维生素 D 不足很常见。循环维生素 D 与基线疼痛、肿胀关节和 DAS28 的未调整相关性可由季节、年龄和性别差异来解释，在多变量分析中无统计学意义。与北欧早期炎症性关节炎的报告不同，25（OH）-D 浓度与非裔美国人 RA 患者的症状或疾病严重程度之间没有很强的相关性。
