title: Prevalence of vitamin D deficiency in rheumatoid arthritis and association with disease activity and cardiovascular risk factors: data from the COMEDRA study.
abstract: OBJECTIVE
  The relationship between vitamin D and rheumatoid arthritis (RA) activity remains controversial. RA is a cardiovascular risk factor. A low level of vitamin D may increase blood pressure (BP) and decrease HDL-cholesterol. We aimed to determine the prevalence of vitamin D deficiency in RA patients compared to controls, and also to investigate the relationship between vitamin D and RA activity, and between vitamin D and cardiovascular risk factors.
  
  
  METHODS
  Patients in the COMEDRA study with established inactive RA (1987 ACR criteria) were matched with subjects from the NUTRINET-SANTE cohort (age, gender, latitude, sampling season). Vitamin D deficiency was defined as <10 ng/mL, and insufficiency as 10 to 29.9 ng/mL.
  
  
  RESULTS
  Eight hundred and ninety-four RA patients were analysed, of which 861 were matched with controls. The prevalence of vitamin D insufficiency and deficiency was lower in RA patients than in controls: 480 (55.8%) vs. 508 (59%) and 31 (3.6%) vs. 45 (5.23%), respectively; p=0.04. There was an inverse correlation between vitamin D levels and RA activity assessed by DAS28-CRP (p=0.01), SDAI (p<0.001) and CDAI (p=0.001), but not DAS28-ESR after adjustment for age, gender, inclusion season, body mass index (BMI), vitamin D supplementation, disease duration, RF or anti-CCP status and RA treatments. Vitamin D levels were inversely correlated with BMI (p<0.001), but not with BP, total cholesterol, LDL-cholesterol, HDL-cholesterol or blood glucose.
  
  
  CONCLUSIONS
  This study demonstrates that vitamin D is inversely correlated with RA activity and BMI, but not with other cardiovascular risk factors.
authors.affiliation: Department of Rheumatology, Clermont-Ferrand University Hospital, France.
authors.forename: Stella
authors.initials: S
authors.lastname: Cecchetti
authors.affiliation: Department of Rheumatology, Clermont-Ferrand University Hospital, France.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Tatar
authors.affiliation: Paris 13 University, Sorbonne Paris Cité, Nutritional Epidemiology Research Unit, INSERM (U1153), Bobigny, France.
authors.forename: Pilar
authors.initials: P
authors.lastname: Galan
authors.affiliation: Biostatistics Department, Clermont-Ferrand University Hospital, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Pereira
authors.affiliation: Biostatistics Department, Clermont-Ferrand University Hospital, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Lambert
authors.affiliation: Department of Rheumatology, Lapeyronie Hospital, Montpellier 1 University, EA2415, Montpellier, France.
authors.forename: Gael
authors.initials: G
authors.lastname: Mouterde
authors.affiliation: Biochemistry Department, Jean Verdier Hospital, APHP, Bondy; Paris 13 University, Sorbonne Paris Cité, Laboratory for Vascular Translational Science, INSERM (U1148), Bobigny, France.
authors.forename: Angela
authors.initials: A
authors.lastname: Sutton
authors.affiliation: Department of Rheumatology, Clermont-Ferrand University Hospital, France. msoubrier@chu-clermontferrand.fr.
authors.forename: Martin
authors.initials: M
authors.lastname: Soubrier
authors.affiliation: Paris Descartes University, Department of Rheumatology, Hôpital Cochin, Assistance Publique, Hôpitaux de Paris, INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000209:etiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications / Q000453:epidemiology*
chemical_list: D015415:Biomarkers; D014807:Vitamin D