title: Vitamin D deficiency in patients with either rheumatic diseases or inflammatory bowel diseases on biologic therapy.
abstract: Vitamin D deficiency has been reported in patients with chronic inflammatory conditions, such as rheumatic and inflammatory bowel diseases (IBD). We evaluated the role of biologic therapy on vitamin D, calcium and parathormone (PTH) levels. This cross-sectional study enrolled consecutive patients with either rheumatic diseases or IBD who underwent an ambulatory visit. Patients receiving vitamin D/calcium supplementation were excluded. Vitamin D deficiency or insufficiency was diagnosed when values were <20 ng/mL and 21-29 ng/ml, respectively. Patients were sub-grouped according to biologic therapy. A multivariate analysis was performed. Two-hundred patients, including 136 with a rheumatic disease (M/F 37/99; mean age 60.7 ± 12.9 years) and 64 with IBD (M/F 41/23; Mean age 49.6 ± 13.1 years) were enrolled. Vitamin D deficiency/insufficiency was detected in as many as 63.5 % patients, being 61.8 and 67.2 % in patients with either rheumatic diseases or IBD, respectively. The prevalence of vitamin D deficiency/insufficiency was higher in those receiving biologics than other therapies (78.3 vs 43.2 %; p < 0.0001), in either rheumatic diseases (78.7 vs 41 %; p < 0.0001) or IBD (75 vs 50 %; p = 0.03) group. At multivariate analysis, only biologic therapy was independently associated with vitamin D deficit (OR 4.61; p = 0.001). Patients with vitamin D deficiency/insufficiency had hypocalcemia more frequently than controls (22.8 vs 10.9 %; p = 0.03), while PTH values did not differ significantly. This study finds that the prevalence of vitamin D deficiency/insufficiency was very high in patients with either rheumatic diseases or IBD receiving a biologic therapy.
authors.affiliation: Medicina Interna, Reumatologia e Gastroenterologia, Ospedale Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bruzzese
authors.affiliation: Medicina Interna, Reumatologia e Gastroenterologia, Ospedale Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy. angelozullo66@yahoo.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Zullo
authors.affiliation: Allergy, Clinical Immunology and Rheumatology, 'Sapienza'University of Rome, S. Andrea University Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Picchianti Diamanti
authors.affiliation: Gastroenterology Unit, Sapienza University of Rome "Polo Pontino" Hospital, Latina, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ridola
authors.affiliation: Medicina Interna, Reumatologia e Gastroenterologia, Ospedale Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lorenzetti
authors.affiliation: Medicina Interna, Reumatologia e Gastroenterologia, Ospedale Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Marrese
authors.affiliation: Medicina Interna, Reumatologia e Gastroenterologia, Ospedale Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy.
authors.forename: Palma
authors.initials: P
authors.lastname: Scolieri
authors.affiliation: Gastroenteroolgy Unit, 'RiUniti' Hospital, Foggia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Francesco
authors.affiliation: Medicina Interna, Reumatologia e Gastroenterologia, Ospedale Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.affiliation: Rheumatology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Migliore
authors.affiliation: Allergy, Clinical Immunology and Rheumatology, 'Sapienza'University of Rome, S. Andrea University Hospital, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Laganà
mesh_terms: D000368:Aged; D001691:Biological Therapy / Q000009:adverse effects* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010045:Outpatients / Q000706:statistics & numerical data; D012216:Rheumatic Diseases / Q000150:complications / Q000628:therapy*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000209:etiology*
keywords: Biologic therapy; Inflammatory bowel disease; Rheumatic disease; Vitamin D