The D-vitamin metabolite 1,25(OH) 2D in serum is associated with disease activity and Anti-Citrullinated Protein Antibodies in active and treatment naïve, early Rheumatoid Arthritis Patients

Mette Herly, Kristian Stengaard-Pedersen, Peter Vestergaard, Mikkel Østergaard, Peter Junker, Merete Lund Hetland, Kim Hørslev-Petersen, Torkell Ellingsen

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Abstract

Rationale: Sufficient levels of vitamin D seem to be essential for proper immune function, and low levels might be associated to disease activity in Rheumatoid Arthritis (RA). Most studies investigate only 25OHD and not the physiologically active vitamin D metabolite, 1,25(OH) 2D. Objective: To investigate associations between serum level of vitamin D metabolites and disease activity parameters in 160 inflammatory active and treatment naïve early RA patients. Serum level of vitamin D metabolites (25OHD 2, 25OHD 3 and 1,25(OH) 2D) was measured by isotope dilution mass spectrometry and radio-immunoassays at baseline. Disease characteristics were gender, number of tender joints, number of swollen joints, DAS28-CRP, HAQ, VAS-scores, CRP, erosive status (Total Sharp Score; TSS), ACPA and IgM-RF-status. Associations were evaluated using Spearman's and Wilcoxon rank-sum tests. The study was registered in clinical trials; trial registration number: NCT00209859. Findings: Statistically significant inverse associations were found between the active metabolite 1,25(OH) 2D and DAS28-CRP (P = 0.004, rho = −0.23), HAQ (P = 0.005, rho = −0.22), CRP (P = 0.001, rho = −0.25), VAS patient-pain (P = 0.008, rho = −0.21), and a positive association was found to ACPA-status (P = 0.04). Conclusion: The vitamin D metabolite 1,25(OH) 2D was inversely associated with disease activity and positively associated with ACPA in treatment naïve and inflammatory active early RA. The results indicate that in RA, both the degree of inflammatory activity, and the diagnostic sensitivity and specificity might affect—or might be affected by the level of vitamin 1,25(OH) 2D.

Original languageEnglish
Article numbere12704
JournalScandinavian Journal of Immunology
Volume88
Issue number3
Number of pages9
ISSN0300-9475
DOIs
Publication statusPublished - Sep 2018

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Serum
Nonparametric Statistics
Proteins
Joints
Radio
Immunoassay
Vitamins
Isotopes
Clinical Trials

Keywords

  • Adult
  • Aged
  • Anti-Citrullinated Protein Antibodies/blood
  • Antirheumatic Agents/therapeutic use
  • Arthritis, Rheumatoid/diagnosis
  • Biomarkers/blood
  • Calcitriol/blood
  • Disease Progression
  • Ergocalciferols/blood
  • Female
  • Humans
  • Immunity, Humoral
  • Male
  • Middle Aged
  • Severity of Illness Index
  • Vitamin D/analogs & derivatives
  • Young Adult

Cite this

@article{507b170ed9f14a11b2359bf52fcbd3bb,
title = "The D-vitamin metabolite 1,25(OH) 2D in serum is associated with disease activity and Anti-Citrullinated Protein Antibodies in active and treatment na{\"i}ve, early Rheumatoid Arthritis Patients",
abstract = "Rationale: Sufficient levels of vitamin D seem to be essential for proper immune function, and low levels might be associated to disease activity in Rheumatoid Arthritis (RA). Most studies investigate only 25OHD and not the physiologically active vitamin D metabolite, 1,25(OH) 2D. Objective: To investigate associations between serum level of vitamin D metabolites and disease activity parameters in 160 inflammatory active and treatment na{\"i}ve early RA patients. Serum level of vitamin D metabolites (25OHD 2, 25OHD 3 and 1,25(OH) 2D) was measured by isotope dilution mass spectrometry and radio-immunoassays at baseline. Disease characteristics were gender, number of tender joints, number of swollen joints, DAS28-CRP, HAQ, VAS-scores, CRP, erosive status (Total Sharp Score; TSS), ACPA and IgM-RF-status. Associations were evaluated using Spearman's and Wilcoxon rank-sum tests. The study was registered in clinical trials; trial registration number: NCT00209859. Findings: Statistically significant inverse associations were found between the active metabolite 1,25(OH) 2D and DAS28-CRP (P = 0.004, rho = −0.23), HAQ (P = 0.005, rho = −0.22), CRP (P = 0.001, rho = −0.25), VAS patient-pain (P = 0.008, rho = −0.21), and a positive association was found to ACPA-status (P = 0.04). Conclusion: The vitamin D metabolite 1,25(OH) 2D was inversely associated with disease activity and positively associated with ACPA in treatment na{\"i}ve and inflammatory active early RA. The results indicate that in RA, both the degree of inflammatory activity, and the diagnostic sensitivity and specificity might affect—or might be affected by the level of vitamin 1,25(OH) 2D.",
keywords = "Adult, Aged, Anti-Citrullinated Protein Antibodies/blood, Antirheumatic Agents/therapeutic use, Arthritis, Rheumatoid/diagnosis, Biomarkers/blood, Calcitriol/blood, Disease Progression, Ergocalciferols/blood, Female, Humans, Immunity, Humoral, Male, Middle Aged, Severity of Illness Index, Vitamin D/analogs & derivatives, Young Adult",
author = "Mette Herly and Kristian Stengaard-Pedersen and Peter Vestergaard and Mikkel {\O}stergaard and Peter Junker and Hetland, {Merete Lund} and Kim H{\o}rslev-Petersen and Torkell Ellingsen",
note = "This article is protected by copyright. All rights reserved.",
year = "2018",
month = "9",
doi = "10.1111/sji.12704",
language = "English",
volume = "88",
journal = "Scandinavian Journal of Immunology",
issn = "0300-9475",
publisher = "Wiley-Blackwell",
number = "3",

}

The D-vitamin metabolite 1,25(OH) 2D in serum is associated with disease activity and Anti-Citrullinated Protein Antibodies in active and treatment naïve, early Rheumatoid Arthritis Patients. / Herly, Mette; Stengaard-Pedersen, Kristian; Vestergaard, Peter; Østergaard, Mikkel; Junker, Peter; Hetland, Merete Lund; Hørslev-Petersen, Kim; Ellingsen, Torkell.

In: Scandinavian Journal of Immunology, Vol. 88, No. 3, e12704, 09.2018.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The D-vitamin metabolite 1,25(OH) 2D in serum is associated with disease activity and Anti-Citrullinated Protein Antibodies in active and treatment naïve, early Rheumatoid Arthritis Patients

AU - Herly, Mette

AU - Stengaard-Pedersen, Kristian

AU - Vestergaard, Peter

AU - Østergaard, Mikkel

AU - Junker, Peter

AU - Hetland, Merete Lund

AU - Hørslev-Petersen, Kim

AU - Ellingsen, Torkell

N1 - This article is protected by copyright. All rights reserved.

PY - 2018/9

Y1 - 2018/9

N2 - Rationale: Sufficient levels of vitamin D seem to be essential for proper immune function, and low levels might be associated to disease activity in Rheumatoid Arthritis (RA). Most studies investigate only 25OHD and not the physiologically active vitamin D metabolite, 1,25(OH) 2D. Objective: To investigate associations between serum level of vitamin D metabolites and disease activity parameters in 160 inflammatory active and treatment naïve early RA patients. Serum level of vitamin D metabolites (25OHD 2, 25OHD 3 and 1,25(OH) 2D) was measured by isotope dilution mass spectrometry and radio-immunoassays at baseline. Disease characteristics were gender, number of tender joints, number of swollen joints, DAS28-CRP, HAQ, VAS-scores, CRP, erosive status (Total Sharp Score; TSS), ACPA and IgM-RF-status. Associations were evaluated using Spearman's and Wilcoxon rank-sum tests. The study was registered in clinical trials; trial registration number: NCT00209859. Findings: Statistically significant inverse associations were found between the active metabolite 1,25(OH) 2D and DAS28-CRP (P = 0.004, rho = −0.23), HAQ (P = 0.005, rho = −0.22), CRP (P = 0.001, rho = −0.25), VAS patient-pain (P = 0.008, rho = −0.21), and a positive association was found to ACPA-status (P = 0.04). Conclusion: The vitamin D metabolite 1,25(OH) 2D was inversely associated with disease activity and positively associated with ACPA in treatment naïve and inflammatory active early RA. The results indicate that in RA, both the degree of inflammatory activity, and the diagnostic sensitivity and specificity might affect—or might be affected by the level of vitamin 1,25(OH) 2D.

AB - Rationale: Sufficient levels of vitamin D seem to be essential for proper immune function, and low levels might be associated to disease activity in Rheumatoid Arthritis (RA). Most studies investigate only 25OHD and not the physiologically active vitamin D metabolite, 1,25(OH) 2D. Objective: To investigate associations between serum level of vitamin D metabolites and disease activity parameters in 160 inflammatory active and treatment naïve early RA patients. Serum level of vitamin D metabolites (25OHD 2, 25OHD 3 and 1,25(OH) 2D) was measured by isotope dilution mass spectrometry and radio-immunoassays at baseline. Disease characteristics were gender, number of tender joints, number of swollen joints, DAS28-CRP, HAQ, VAS-scores, CRP, erosive status (Total Sharp Score; TSS), ACPA and IgM-RF-status. Associations were evaluated using Spearman's and Wilcoxon rank-sum tests. The study was registered in clinical trials; trial registration number: NCT00209859. Findings: Statistically significant inverse associations were found between the active metabolite 1,25(OH) 2D and DAS28-CRP (P = 0.004, rho = −0.23), HAQ (P = 0.005, rho = −0.22), CRP (P = 0.001, rho = −0.25), VAS patient-pain (P = 0.008, rho = −0.21), and a positive association was found to ACPA-status (P = 0.04). Conclusion: The vitamin D metabolite 1,25(OH) 2D was inversely associated with disease activity and positively associated with ACPA in treatment naïve and inflammatory active early RA. The results indicate that in RA, both the degree of inflammatory activity, and the diagnostic sensitivity and specificity might affect—or might be affected by the level of vitamin 1,25(OH) 2D.

KW - Adult

KW - Aged

KW - Anti-Citrullinated Protein Antibodies/blood

KW - Antirheumatic Agents/therapeutic use

KW - Arthritis, Rheumatoid/diagnosis

KW - Biomarkers/blood

KW - Calcitriol/blood

KW - Disease Progression

KW - Ergocalciferols/blood

KW - Female

KW - Humans

KW - Immunity, Humoral

KW - Male

KW - Middle Aged

KW - Severity of Illness Index

KW - Vitamin D/analogs & derivatives

KW - Young Adult

U2 - 10.1111/sji.12704

DO - 10.1111/sji.12704

M3 - Journal article

C2 - 30048002

VL - 88

JO - Scandinavian Journal of Immunology

JF - Scandinavian Journal of Immunology

SN - 0300-9475

IS - 3

M1 - e12704

ER -