Department of Medical Science, BK21 Plus Project, Yonsei University, College of Medicine, Seoul, Korea (Republic of).
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea (Republic of).
Z Rheumatol. 2022 Feb;81(1):77-84. doi: 10.1007/s00393-020-00949-2. Epub 2020 Dec 18.
The association between vitamin D levels and disease activity has been established in patients with several autoimmune rheumatic diseases. We aimed to examine the association between vitamin D and disease activity of antineutrophil cytoplasmic antibody-associated vasculitis (AAV).
Fifty-four AAV patients and 50 age- and sex-matched healthy controls without vitamin D supplements were included. Clinical and laboratory data were evaluated during the assessment of vitamin D levels. Two different forms of vitamin D in the sera-25(OH)D, which is the sum of 25(OH)D2 and 25(OH)D3, and 25(OH)D3, which only includes 25(OH)D in its D3 form-were measured, and the relationship between vitamin D and the obtained data was assessed. Variations in vitamin D levels relative to the season were also evaluated.
Patients with AAV demonstrated considerably lower 25(OH)D serum levels than healthy controls (16.0 vs. 20.4 ng/mL, p = 0.016), and the proportion of individuals with vitamin D deficiency was higher in patients with AAV than in healthy controls (68.5% vs. 48.0%, p = 0.035). Both serum 25(OH)D and 25(OH)D3 were positively associated with the 36-item Short-form Health Survey (SF-36) physical component summary and SF-36 mental component summary (MCS) scores. A negative correlation was observed between 25(OH)D and 25(OH)D3 serum levels and Birmingham vasculitis activity score (BVAS), C‑reactive protein (CRP), and white blood cell count. Linear regression analysis indicated haemoglobin and 25(OH)D levels to be independently associated with BVAS and CRP and 25(OH)D levels with SF-36 MCS score. No seasonal variations were observed in vitamin D levels.
The results from this study suggest that vitamin D levels could provide clinically useful information in AAV.
维生素 D 水平与几种自身免疫性风湿病患者的疾病活动之间存在关联。我们旨在研究维生素 D 与抗中性粒细胞胞浆抗体相关性血管炎(AAV)的疾病活动之间的关系。
纳入 54 例 AAV 患者和 50 名年龄和性别匹配、未服用维生素 D 补充剂的健康对照者,评估维生素 D 水平的同时评估临床和实验室数据。检测血清中两种不同形式的维生素 D-25(OH)D,其为 25(OH)D2 和 25(OH)D3 的总和,以及仅以 25(OH)D3 形式存在的 25(OH)D3,并评估维生素 D 与获得的数据之间的关系。还评估了维生素 D 水平相对于季节的变化。
AAV 患者的血清 25(OH)D 水平明显低于健康对照组(16.0 对 20.4 ng/mL,p = 0.016),AAV 患者维生素 D 缺乏的比例高于健康对照组(68.5%对 48.0%,p = 0.035)。血清 25(OH)D 和 25(OH)D3 均与 36 项简明健康调查(SF-36)身体成分综合评分和 SF-36 心理成分综合评分(MCS)呈正相关。25(OH)D 与 25(OH)D3 血清水平与 Birmingham 血管炎活动评分(BVAS)、C 反应蛋白(CRP)和白细胞计数呈负相关。线性回归分析表明,血红蛋白和 25(OH)D 水平与 BVAS 和 CRP 独立相关,25(OH)D 水平与 SF-36 MCS 评分独立相关。未观察到维生素 D 水平的季节性变化。
本研究结果表明,维生素 D 水平可能为 AAV 提供有临床意义的信息。