Association between Vitamin D Deficiency and Carotid Intima-media Thickness in Patients with Rheumatoid Arthritis

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¹ÚÁ¾¸¸(Park Jong-Man) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
À̽±Ù(Lee Seung-Geun) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
¹ÚÀº°æ(Park Eun-Kyoung) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
À̴뼺(Lee Dae-Sung) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
¹é¼º¹Î(Baek Sung-Min) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
Ȳ°æ¸²(Hwang Kyung-Lim) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
±èÁß±Ù(Kim Joong-Keun) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
(Park Ji-Heh) - Pusan National University School of Medicine Pusan National University Hospital Department of Internal Medicine
±è±ÙÅÂ(Kim Geun-Tae) - Kosin University College of Medicine Department of Internal Medicine
ÃÖ¼±À±(Choi Seon-Yoon) - Kosin University College of Medicine Department of Internal Medicine

Abstract

Objective: The present study determined if vitamin D defi-ciency is a potential risk factor for increased carotid in-tima-media thickness (CIMT) in patients with rheumatoid arthritis (RA).

Methods: This cross-sectional study analyzed 50 consecutive female RA patients without cardiovascular disease history at the Pusan National University Hospital between September and December of 2013. CIMT was measured us-ing a high-resolution ultrasonography. Serum 25-hydroxy vitamin D (25-OHD) levels were assessed by radioimmuno-assay, and vitamin D deficiency was defined as serum 25-OHD levels £¼20 ng/mL. Stepwise multivariable linear regression analyses were performed to evaluate the associa-tion between vitamin D deficiency and increased CIMT.

Results: The median 25-OHD level (inter-quartile range) was 14.0 (11.0¡­20.7) ng/mL, and 74% of patients had vita-min D deficiency. The mean¡¾standard deviation of CIMT was 0.58¡¾0.08 mm. RA patients with vitamin D deficiency had significantly higher CIMT than those without this fea-ture (0.59¡¾0.07 vs 0.54¡¾0.05, p=0.028). In univariable line-ar regression models, vitamin D deficiency (¥â(SE)=0.047 (0.021), p=0.028), older age (¥â(SE)=0.003 (7.2-4), p£¼0.001) and higher disease activity score 28-erythrocyte sed-imentation rate (¥â(SE)=0.021 (0.010), p=0.034) and Korean version of health assessment questionnaire score (¥â(SE)=0.051 (0.015), p=0.002) were significantly asso-ciated with increased CIMT. Vitamin D deficiency re-mained statistically significant in multivariable regression models after adjusting for confounders.

Conclusion: Vitamin D deficiency was associated with in-creased CIMT in female RA patients. Our finding suggests that hypovitaminosis D can be a risk factor for athero-sclerosis in RA patients.

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Vitamin D, Rheumatoid arthritis, Atheroscle-rosis, Cardiovascular diseases
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DOI
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