VITAMIN D AND ITS CLINICAL SIGNIFICANCE IN JUVENILE IDIOPATHIC ARTHRITIS – June 2017
Otilia Marginean1,2 Andrea Somogyi Militaru3, Oana Belei1,2 Raluca Corina Tamasanu1, Ioana Mozos4,5 ioanamozos at yahoo.de, Mirabela Dima6, Giorgiana Flavia Brad1,2 Niculina Mang1, Teofana Otilia Bizerea1 11st Pediatric Clinic.’’Victor Babe§” University of Medicine and Pharmacy, Timisoara, Romania
Vitamin D is known especially for its bone effects. Juvenile idiopathic arthritis (JIA) is one of the most common rheumatic diseases in childhood. It was the aim of the present study to evaluate vitamin D status in patients with JIA and to assess the relationship between vitamin D levels and disease activity. A total of 44 patients with JIA, diagnosed according to the International League Against Rheumatism (ILAR) criteria and a control group (n=13), matched for age and sex, with no musculoskeletal complaints, were evaluated. Disease activity was assessed, X-ray was performed in clinically active joints, with disease duration more than 6 months and vitamin D level was measured. Significant lower values were obtained for vitamin D in JIA patients compared to the healthy controls, especially in patients
Determinants of Vitamin D Levels in Children, Adolescents, and Young Adults with Juvenile Idiopathic Arthritis - Aug 2014
J Rheumatol. 2014 Aug 1. pii: jrheum.131421. [Epub ahead of print]
Stagi S, Bertini F, Cavalli L, Matucci-Cerinic M, Brandi ML, Falcini F.
Deficiency of 25-hydroxyvitamin D [25(OH)D] is reported to be common in patients with rheumatoid arthritis (RA); data in patients with juvenile idiopathic arthritis (JIA) are inconsistent. We assessed serum 25(OH)D in children, adolescents and young adults with JIA, in order to identify the risk factors for vitamin D deficiency in patients with JIA.
We evaluated 152 patients with JIA: 115 female, 37 male, mean age 16.2 ± 7.4 yrs; evaluated by onset type, 96 had oligoarticular, 35 polyarticular, 7 systemic, and 14 enthesitis-related arthritis (ERA). Patients were compared with a control group matched for sex and age. All patients and controls underwent laboratory tests of plasma 25(OH)D, parathyroid hormone (PTH), calcium, phosphorus, and bone alkaline phosphatase levels, and dual-energy x-ray absorptiometry examination.
Patients with JIA showed significantly reduced 25(OH)D levels compared to controls (p < 0.001), even divided into subtypes (
- oligoarticular, p < 0.05;
- polyarticular, p < 0.005;
- systemic, p < 0.001;
- ERA, p < 0.005).
Patients with active disease and/or frequent relapses had significantly reduced 25(OH)D levels compared to patients with no active disease and no frequent flares (p < 0.005, respectively). Nevertheless, JIA patients had significantly higher PTH levels compared to controls (p < 0.0001). JIA patients with 25(OH)D deficiency showed a significantly lower bone mineral apparent density than those with normal 25(OH)D levels (p < 0.001).
JIA patients have reduced 25(OH)D and higher PTH values. This may explain at least in part why JIA patients, despite more effective current drugs, do not achieve bone-normal condition over time. JIA patients with more severe disease could require higher supplementation of vitamin D to maintain normal 25(OH)D serum levels. Longterm studies are needed to investigate the relationship between serum 25(OH)D levels and disease activity in JIA.
Download the PDF from VitaminDWiki
See also VitaminDWiki
- Children with Idiopathic arthritis have very low Boron levels – Jan 2016
- Juvenile Rheumatoid Arthritis 8 X more likely if poor Vitamin D receptor – Dec 2017
- Juvenile Rheumatoid Arthritis associated with low vitamin D, but how low – review Jan 2013 which has a chart showing how rarity of JIA