title: The Role of 25-Hydroxyvitamin D as a Predictor of Clinical and Radiological Outcomes in Early Onset Rheumatoid Arthritis.
abstract: OBJECTIVE
  The aims of this study were to compare the levels of 25-hydroxyvitamin D (25(OH)D) in patients with early-onset rheumatoid arthritis (EORA) versus a healthy control group and to assess the association of 25(OH)D deficiency and the BsmI polymorphism of the vitamin D receptor gene with clinical, radiological, and laboratory parameters.
  
  
  METHODS
  Early-onset RA Colombian patients were enrolled in a 3-year follow-up study. Vitamin D deficiency was diagnosed for 25(OH)D levels of less than 20 ng/mL. Pearson and Spearman correlation coefficients were used to assess data.
  
  
  RESULTS
  Seventy patients and 70 matched healthy subjects were included. 25-Hydroxyvitamin D was lower in the EORA group (27.13 [SD, 13.4] ng/mL vs. 33.74 [SD, 16.7] ng/mL; P = 0.01); 31.4% of EORA patients were vitamin D deficient. Remission was higher in subjects without 25(OH)D deficiency (22.7% vs. 47.9%; P = 0.04). Patients with 25(OH)D deficiency at baseline had higher Health Assessment Questionnaire and Physician Global Disease Activity Assessment scores, fatigue levels, erythrocyte sedimentation rate, and morning stiffness after 3 years. At disease onset, only a relationship between 25(OH)D deficiency with fatigue and morning stiffness was found. Neither radiographic progression nor Sharp van der-Heidje score was associated to hypovitaminosis D after 36-month follow-up. The bb genotype was less frequent in patients with vitamin D deficiency (0% vs. 16.6%; P = 0.04). Patients with BB-Bb genotype had lower 25(OH)D and a propensity to more severe disease.
  
  
  CONCLUSIONS
  Our data provide further support for a role of vitamin D as a clinical biomarker for RA. Baseline 25(OH)D could have potential as a predictor of disease severity in EORA.
authors.affiliation: From the *Faculty of Medicine, Fundación Universitaria Autónoma de las Américas, Pereira; and †Genetics Institute, ‡Faculty of Medicine, §Radiology Unit, ∥Pathology Unit, Genetic Institute, and ¶Rheumatology Unit, Faculty of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
authors.forename: Mario Andrés
authors.initials: MA
authors.lastname: Quintana-Duque
authors.forename: Jorge Eduardo
authors.initials: JE
authors.lastname: Caminos
authors.forename: Adriana
authors.initials: A
authors.lastname: Varela-Nariño
authors.forename: Enrique
authors.initials: E
authors.lastname: Calvo-Paramo
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Yunis
authors.forename: Antonio
authors.initials: A
authors.lastname: Iglesias-Gamarra
mesh_terms: D000328:Adult; D017668:Age of Onset; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D003105:Colombia / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011859:Radiography / Q000379:methods / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D