Abourazzak F E, Talbi S, Aradoini N, Berrada K, Keita S, Hazry T
Rheumatology Department, Hassan II University Hospital, Fez, Morocco,
Clin Rheumatol. 2015 Feb;34(2):353-7. doi: 10.1007/s10067-014-2713-0. Epub 2014 Jun 13.
The objective of this study is to evaluate the prevalence of vitamin D insufficiency in patients with rheumatoid arthritis (RA) and its association with disease activity, severity and physical disability. We included patients with rheumatoid arthritis followed in Rheumatology Department of Hassan II University Hospital, Fez, Morocco. Patients suffering from liver and kidney insufficiency and those who had received vitamin D in the previous 12 months have been excluded. Statistical analysis was done using SPSS v 18. A bivariate analysis and logistic regression were used to identify factors associated with vitamin D deficiency. One hundred seventy patients were included with a mean age of 50 ± 12.1 [17-83] years, and a female predominance (88.1%). All of our patients had hypovitaminosis D. The prevalence of 25(OH)-D insufficiency and deficiency was 64.5 and 35.5% successively. In unadjusted analysis, vitamin D concentration was inversely associated with pain visual analog scale VAS score (p < 0.001), asthenia VAS (p < 0.001), morning stiffness (p = 0.03), number of tender joints (p = 0.004), number of swollen joints (p < 0.001), inflammatory markers (p = 0,012), Disease Activity Score (p = 0.009), physical disability using Health Assessment Questionnaire (HAQ) (p = 0.001), and severity of the disease (p < 0.001). After logistic regression persisted association with female sex (OR = 4.3, CI = [0.94 to 20.976], p = 0.05), asthenia VAS (OR = 1.029, CI = [1.011 to 1.046], p = 0.001), and with the severity of the disease (OR = 2.910, CI = [1.314-6.441], p = 0.008). The vitamin D deficiency is common in our patients with RA. This deficiency is associated with female sex, severe asthenia, and the severity of the disease.
本研究的目的是评估类风湿关节炎（RA）患者维生素D不足的患病率及其与疾病活动度、严重程度和身体残疾的关联。我们纳入了摩洛哥非斯哈桑二世大学医院风湿病科随访的类风湿关节炎患者。排除患有肝肾功能不全的患者以及在过去12个月内接受过维生素D治疗的患者。使用SPSS v 18进行统计分析。采用双变量分析和逻辑回归来确定与维生素D缺乏相关的因素。共纳入170例患者，平均年龄为50±12.1[17 - 83]岁，女性占优势（88.1%）。我们所有患者均存在维生素D缺乏症。25(OH)-D不足和缺乏的患病率分别为64.5%和35.5%。在未校正分析中，维生素D浓度与疼痛视觉模拟量表（VAS）评分（p < 0.001）、乏力VAS评分（p < 0.001）、晨僵（p = 0.03）、压痛关节数（p = 0.004）、肿胀关节数（p < 0.001）、炎症标志物（p = 0.012）、疾病活动评分（p = 0.009）、使用健康评估问卷（HAQ）评估的身体残疾（p = 0.001）以及疾病严重程度（p < 0.001）呈负相关。逻辑回归分析后发现，维生素D缺乏仍与女性性别（OR = 4.3，CI = [0.94至20.976]，p = 0.05）、乏力VAS评分（OR = 1.029，CI = [1.011至1.046]，p = 0.001）以及疾病严重程度（OR = 2.910，CI = [1.314 - 6.441]，p = 0.008）相关。维生素D缺乏在我们的类风湿关节炎患者中很常见。这种缺乏与女性性别、严重乏力和疾病严重程度相关。
