Çomak Elif, Doğan Çağla Serpil, Uslu-Gökçeoğlu Arife, Akbaş Halide, Özdem Sabahat, Koyun Mustafa, Akman Sema
Division of Pediatric Nephrology and Rheumatology, Department of Pediatrics, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
Turk J Pediatr. 2014 Nov-Dec;56(6):626-31.
Vitamin D has been shown to have immunomodulatory and anti-inflammatory properties in addition to its well-established role in the maintenance of mineral homeostasis and bone health. The aims of this study were to evaluate vitamin D status in patients with juvenile idiopathic arthritis (JIA), and also to examine whether there is an association between serum levels of 25-hydroxyvitamin D [25(OH)D] and disease activity in JIA. Children with JIA who had an outpatient visit between March and April 2011 were evaluated retrospectively. Clinical and laboratory findings and vitamin D levels were evaluated. Disease activity was calculated using JADAS-27. Serum vitamin D levels were measured using high-performance liquid chromatography (HPLC). A total of 47 patients, 29 (61.7%) of them girls, with a mean age of 9.3±3.9 years and a median follow-up period of 28 months, were included in the study. The mean serum vitamin D level of all patients was 17.7±11.6 ng/ml. Vitamin D insufficiency (serum vitamin D: 15-20 ng/ml) and deficiency (serum vitamin D level <15 ng/ml) were found in 9 (19.1%) and 25 patients (53.2%), respectively. The vitamin D level was <20 ng/ml in 72.3% of the children. Only 13 patients (27.7%) were found to have adequate vitamin D levels (>20 ng/ml). There was a significant negative correlation between vitamin D levels and disease activity (p=0.01, r=-0,37). The mean JADAS-27 score was significantly higher in patients with 25(OH)D levels <15 ng/ml than in patients with 25(OH)D levels >15 ng/ml (p = 0.003). We suggest that vitamin D deficiency may be a possible modifiable risk factor affecting disease activity in JIA.
维生素D除了在维持矿物质稳态和骨骼健康方面具有公认作用外，还具有免疫调节和抗炎特性。本研究的目的是评估幼年特发性关节炎（JIA）患者的维生素D状态，并检查血清25-羟维生素D [25(OH)D]水平与JIA疾病活动之间是否存在关联。对2011年3月至4月期间门诊就诊的JIA患儿进行回顾性评估。评估临床和实验室检查结果以及维生素D水平。使用JADAS-27计算疾病活动度。采用高效液相色谱法（HPLC）测量血清维生素D水平。共有47例患者纳入研究，其中29例（61.7%）为女孩，平均年龄9.3±3.9岁，中位随访期28个月。所有患者的平均血清维生素D水平为17.7±11.6 ng/ml。分别有9例（19.1%）和25例（53.2%）患者存在维生素D不足（血清维生素D：15 - 20 ng/ml）和缺乏（血清维生素D水平<15 ng/ml）。72.3%的儿童维生素D水平<20 ng/ml。仅13例（27.7%）患者维生素D水平充足（>20 ng/ml）。维生素D水平与疾病活动度之间存在显著负相关（p = 0.01，r = -0.37）。25(OH)D水平<15 ng/ml的患者JADAS-27平均评分显著高于25(OH)D水平>15 ng/ml的患者（p = 0.003）。我们认为维生素D缺乏可能是影响JIA疾病活动度的一个可能可改变的危险因素。
