Division of Pediatric Rheumatology, Floating Hospital for Children at Tufts Medical Center, 800 Washington St Box #190, Boston, MA 02111, USA.
Rheumatol Int. 2012 Dec;32(12):3923-9. doi: 10.1007/s00296-011-2287-y. Epub 2011 Dec 25.
The aims of this study were to examine the association between serum levels of 25-hydroxyvitamin D [25(OH)D] and disease activity in juvenile idiopathic arthritis (JIA), to determine the prevalence of vitamin D (VD) deficiency [25(OH)D ≤ 19 ng/ml] and insufficiency [25(OH)D 20-29 ng/ml], and to determine factors associated with lower serum levels of 25(OH)D in this population. In this cross-sectional study, disease activity was measured using JADAS-27, as well as its individual components (physician global assessment of disease activity, parent global assessment of child's well-being, count of joints with active disease, and erythrocyte sedimentation rate). Linear regression models were developed to analyze the association between serum 25(OH)D levels and JADAS-27 and to determine variables associated with serum 25(OH)D levels. A total of 154 patients (61% girls, 88% whites) were included. Mean age was 10.6. VD deficiency was detected in 13% and insufficiency in 42%. In univariate and multivariate analyses, 25(OH)D levels were not associated with JADAS-27, neither with its individual components. However, in a subset analysis including all new-onset JIA patients (n = 27), there was a nonsignificant negative correlation between serum 25(OH)D levels and JADAS-27 (r = -0.29, P = 0.14). In the univariate and multivariate analyses, age, ethnicity, BMI, and season were significantly associated with serum 25(OH)D levels, but not total VD intake. More than 1/2 of JIA patients had serum 25(OH)D levels below 29 ng/ml; however, there was no association between serum 25(OH)D levels and disease activity. Future larger, long-term studies with new-onset JIA patients are needed to further explore the association between serum 25(OH)D levels and disease activity.
本研究旨在探讨血清 25-羟维生素 D [25(OH)D] 水平与幼年特发性关节炎 (JIA) 疾病活动之间的相关性，确定维生素 D (VD) 缺乏症 [25(OH)D ≤ 19ng/ml] 和不足症 [25(OH)D 20-29ng/ml] 的患病率，并确定该人群中与血清 25(OH)D 水平较低相关的因素。在这项横断面研究中，使用 JADAS-27 以及其各个组成部分（医生对疾病活动的整体评估、家长对孩子健康的整体评估、活跃疾病关节计数和红细胞沉降率）来衡量疾病活动。建立线性回归模型来分析血清 25(OH)D 水平与 JADAS-27 之间的关系，并确定与血清 25(OH)D 水平相关的变量。共纳入 154 例患者（61%为女孩，88%为白人）。平均年龄为 10.6 岁。13%存在 VD 缺乏症，42%存在 VD 不足症。在单变量和多变量分析中，25(OH)D 水平与 JADAS-27 及其各个组成部分均无相关性。然而，在包括所有新发病 JIA 患者的亚组分析中（n=27），血清 25(OH)D 水平与 JADAS-27 之间存在无统计学意义的负相关（r=-0.29，P=0.14）。在单变量和多变量分析中，年龄、种族、BMI 和季节与血清 25(OH)D 水平显著相关，但与总 VD 摄入量无关。超过 1/2 的 JIA 患者血清 25(OH)D 水平低于 29ng/ml；然而，血清 25(OH)D 水平与疾病活动之间没有关联。需要进一步进行更大规模、长期的新发病 JIA 患者研究，以进一步探讨血清 25(OH)D 水平与疾病活动之间的关系。
