Does Vitamin D Deficiency affect severity of Rheumatoid Arthritis?

Objective: To determine frequency of Vitamin D deficiency in patients with Rheumatoid Arthritis (RA) and determine its association with disease severity.Methodology: This cross-sectional analytical study was conducted at Departments of Medicine & Allied at CMA Hospital, Azra Naheed Medical College, Superior University Lahore from August 2021 to April 2022. After IRB approval, 266 patients aged 21 to 80 years of both genders diagnosed with RA were enrolled. Demographic information, medical history and clinical parameters of DAS-28 score were assessed and divided into 2 equal groups: active disease (DAS-28 score >3.2) and LDA/remission (DAS-28 score <3.2). Vitamin D levels were assessed and recorded.Results: Mean age and duration of disease were 42.6 +/- 14.3 and 8.4 +/- 6.9 years with 219 (82.3%) females. Mean ESR, VAS score, tender joint count, swollen joint count and DAS-28 score were 32.6 +/- 23.8 mm/hr, 3.9 +/- 2.8, 4.2 +/- 4.1, 2.4 +/- 2.7 and 4.0 +/- 1.6, respectively. RA Factor was positive in 202 (75.9%) and Anti-CCP antibody in 172 (64.7%). Mean Hemoglobin, TLC and platelet counts were 12.2 +/- 1.5 g/dl, 9.1 +/- 2.9x109/L and 354.8 +/- 99.2x109/L, respectively. Mean Vitamin D level was 36.1 +/- 20.7 nmol/l with Vitamin D deficiency in 180 (67.7%). Mean Vitamin D level in LDA/remission group and active disease group were 42.6 +/- 22.1 and 29.6 +/- 17.0 nmol/l, respectively. Vitamin D deficiency was seen in 108 (81.2%) with active disease compared with 72 (54.1%) with LDA/remission.Conclusion: Vitamin D deficiency was more common among patients having active rheumatoid arthritis.