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Vol. 18. Issue 3.
Pages 141-146 (March 2022)
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Vol. 18. Issue 3.
Pages 141-146 (March 2022)
Original article
Vitamin D levels in patients with small and medium vessel vasculitis
Niveles de vitamina D en pacientes con vasculitis de pequeños y vasos medianos
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Fatma Nur Korkmaza,
Corresponding author
f.nur_3717@hotmail.com

Corresponding author.
, Gulsen Ozenb, Ali Ugur Unalc, Asli Odabasid, Meryem Cane, Ebru Asıcıogluf, Serhan Tuglularf, Haner Direskenelic
a Ankara University, School of Medicine, Department of Internal Medicine, Division of Endocrinology, Ankara, Turkey
b University of Nebraska Medical Center, Department of Internal Medicine, Omaha, NE, USA
c Marmara University, School of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul, Turkey
d Marmara University, School of Medicine, Department of Internal Medicine, Istanbul, Turkey
e Medipol Mega Hospitals Complex, Department of Rheumatology, İstanbul, Turkey
f Marmara University, School of Medicine Hospital, Department of Internal Medicine, Division of Nephrology, Istanbul, Turkey
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Tables (4)
Table 1. Demographic characteristics of patients with vasculitis and healthy individuals and 25 hydroxy vitamin D3 levels.b
Table 2. Clinical features of vasculitis patients with and without 25 hydroxy vitamin D3 deficiency.a
Table 3. Correlation of vitamin D3 levels with demographic characteristics and disease activity parameters of patients.
Table 4. Comparison of vasculitis patients with and without vitamin D replacement.
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Abstract
Objectives

To determine the prevalence of vitamin D deficiency in patients with small and medium vessel systemic vasculitis.

Methods

In this cross-sectional study, 25-hydroxy (OH) vitamin D3 levels were measured in adult patients with systemic small and medium vessel vasculitis including antineutrophil cytoplasmic antibody-associated vasculitis (AAV), cryoglobulinaemic vasculitis (CryV), IgA vasculitis (IgAV) and polyarteritis nodosa (PAN), and age- and sex-matched healthy subjects (HS) and patients with rheumatoid arthritis (RA) as control groups. 25OH vitamin D3 levels<30ng/ml and <20ng/ml were regarded as insufficiency and deficiency, respectively.

Results

Fifty-seven patients (42 AAV, 2 CryV, 8 IgA vasculitis, 5 PAN) with systemic vasculitis, 101 HS, and 111 RA patients were included. The mean 25OH vitamin D3 level was 21.8±14.2ng/mL in patients with vasculitis, 42.7±27.6ng/mL in HS (p<.001) and 20.1±18.47ng/mL in patients with RA (p=.54). Vitamin D insufficiency and deficiency were significantly higher in patients with systemic vasculitis compared to HS (75.4% vs 33.7%, p<.001; %50 vs 21.8%, p<.001, respectively). Vitamin D status was not different in patients with systemic vasculitis compared to RA. There was a negative correlation between vitamin D status and CRP levels (=−.364, p=.007). The multivariate logistic regression analysis showed that renal involvement was significantly associated with vitamin D deficiency/insufficiency in patients with vasculitis (OR 22.5 [95% CI 1.6–128.9].

Conclusion

Vitamin D deficiency and insufficiency are more frequent in patients with systemic small and medium vessel vasculitis and RA than HS. Renal involvement is one of the factors associated with vitamin D deficiency/insufficiency in patients with vasculitis.

Keywords:
Vasculitis
Vitamin D
Deficiency
Rheumatoid arthritis
Resumen
Objetivos

Determinar la prevalencia de la deficiencia de vitamina D en los pacientes con vasculitis sistémica de pequeños y medianos vasos.

Métodos

En este estudio transversal se midieron los niveles de 25-hidroxivitamina D3 en pacientes adultos con vasculitis sistémica de pequeños y medianos vasos, incluyendo vasculitis asociada a anticuerpos anticitoplasma de neutrófilos (AAV), vasculitis crioglobulinémica (CryV), vasculitis IgA (IgAV) y poliarteritis nodosa (PAN), y sujetos sanos pareados por edad y sexo (SS) y pacientes con artritis reumatoide (AR) como grupos control. Se consideraron insuficientes y deficientes los niveles de 25-hidroxivitamina D3<30ng/ml y <20ng/ml, respectivamente.

Resultados

Se incluyeron 57 pacientes (42 de AAV, 2 de CryV, 8 de vasculitis IgA y 5 de PAN) con vasculitis sistémica, 101 SS y 111 pacientes de AR. El nivel medio de 25-hidroxivitamina D3 fue de 21,8±14,2ng/ml en pacientes con vasculitis, 42,7±27,6ng/ml en SS (p<0,001) y 20,1±18,47ng/ml en pacientes con AR (p=0,54). La insuficiencia y deficiencia de vitamina D fueron significativamente más altas en los pacientes con vasculitis sistémica en comparación con los SS (75,4 vs. 33,7%; p<0,001; 50 vs. 21,8%; p<0,001, respectivamente). El estatus de vitamina D no fue diferente en los pacientes con vasculitis sistémica en comparación con AR. Existió una correlación negativa entre el estatus de vitamina D y los niveles de PCR=−0,364; p=0,007. El análisis de regresión logística multivariante reflejó que el compromiso renal estuvo significativamente asociado a la deficiencia/insuficiencia de vitamina D en los pacientes con vasculitis (OR: 22,5; IC 95%: 1,6-128,9).

Conclusión

La insuficiencia y deficiencia de vitamina D son más frecuentes en los pacientes con vasculitis sistémica de pequeños y medianos vasos y AR que en los SS. El compromiso renal es uno de los factores asociados a la deficiencia/insuficiencia de vitamina D en los pacientes con vasculitis.

Palabras clave:
Vasculitis
Vitamina D
Deficiencia
Artritis reumatoide

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