Vitamin D, disease activity and comorbidities in early spondyloarthritis.

Ihsane Hmamouchi (1, 2, 3, 4) , Simon Paternotte (1, 2, 4) , Anna Moltó (1, 2, 4) , Adrien Etcheto (1, 2, 4) , Didier Borderie (5, 4) , Bernard Combe (6, 7, 8) , Maxime Dougados (1, 2, 4)

1 Service de rhumatologie [CHU Cochin]
2 CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
3 UM5 - Université Mohammed V de Rabat [Agdal]
4 UPD5 - Université Paris Descartes - Paris 5
5 Hôpital Cochin [AP-HP]
6 Département de Rhumatologie[Montpellier]
7 IGMM - Institut de Génétique Moléculaire de Montpellier
8 AIDMP - Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415

OBJECTIVES: To assess the vitamin D status in patients presenting inflammatory back pain suggestive of axial spondyloarthritis and to assess the relationship between vitamin D status and disease activity/severity; comorbidities at baseline and during the first two years of follow-up. METHODS: DESIR is a prospective, multicentre, observational study. Vitamin D deficiency was defined as <50 nmol/L and severe deficiency less than 25 nmol/L. Clinical variables were collected at each six month interval visits during the two-year follow-up. RESULTS: A total of 700 patients were analysed. The mean vitamin D was 54.2±28.7 nmol/L. Severe deficiency were observed in 11.7% versus 5% in the DESIR cohort versus the French population respectively. In the DESIR cohort, after adjusting for season and ethnicity, vitamin D deficiency remained significantly associated with presence of radiological sacroiliitis, higher ASDAS score and elevated BASDAI. Such association was also found between vitamin D deficiency and the mean value of disease activity/severity parameters during the two-year follow-up. Otherwise, vitamin D deficiency was significantly associated with the presence of baseline abdominal obesity (OR=1.65 [1.05-2.61], p=0.03), low HDL (OR=1.71 [1.14-2.55], p=0.01) and presence of metabolic syndrome (OR=2.20 [1.04-4.64], p=0.03) at baseline. CONCLUSIONS: We found a higher percentage of patients with severe vitamin D deficiency in early axial spondyloarthritis. Vitamin D deficiency was associated with higher disease activity and severity and presence of metabolic syndrome. Further longitudinal studies are required to evaluate the interest of vitamin D supplementation on the long-term outcome of the disease.

Domaines: Rhumatologie et système ostéo-articulaire

Ihsane Hmamouchi, Simon Paternotte, Anna Moltó, Adrien Etcheto, Didier Borderie, et al.. Vitamin D, disease activity and comorbidities in early spondyloarthritis.. Clinical and experimental rheumatology, 2016, 34 (3), pp.396-403. ⟨hal-01872204⟩