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Hypovitaminosis D and response to cholecalciferol supplementation in patients with autoimmune and non-autoimmune rheumatic diseases

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Abstract

Recent reports suggest a role of hypovitaminosis D in the pathogenesis of inflammatory autoimmune diseases (ARD); we investigated 25(OH)vitamin D plasma level before and after supplementation in ARD and NARD (non-ARD: osteoporosis and/or OA) patients. We retrospectively evaluated 572 consecutive clinical records of adult patients at immuno-rheumatology and rehabilitative units of our institution from January 2006 to October 2009. We excluded patients with vitamin D supplementation or renal failure, primary hyperparathyroidism, liver failure. We recorded 25(OH)vitamin D plasma concentration of 245 patients together with other clinical data. We then evaluated 25(OH)vitamin D plasma concentration of 100 (43 ARD and 57 NARD) patients previously included who underwent 750–1,000 UI/die 25(OH)vitamin D supplementation for at least 6 months. Appropriate statistical analysis was performed. The median 25(OH)vitamin D concentration was not significantly different between 119 ARD [33.4 (IQR 22.5–54.9) nmol/l] and 126 NARD patients 32.9 (IQR 18.7–50.2). In stepwise logistic regression, female sex (F:13.7), winter-spring season (F:5.6) and older age (F:5.3), but not ARD, predicted plasma 25(OH)vitamin D <75 nmol/l. Cholecalciferol supplementation increased 25(OH)vitamin D plasma concentration equally in both ARD and NARD; however, only 29/100 patients reached a plasma level ≥75 nmol/l without differences between ARD and NARD (χ2 = n.s.). Hypovitaminosis D is common in rheumatic patients. Sex and age but not ARD are risk factors for this condition. 750–1,000 UI/die of cholecalciferol is not sufficient to normalize plasma level in these patients. Increase of plasma 25(OH)vitamin D after treatment is not influenced by the presence of an inflammatory autoimmune disease.

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Acknowledgments

The study was supported by “Università del Piemonte Orientale Ricerca Locale” research grants.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Immuno-Rheumatology Unit, DMCS Università del Piemonte Orientale “A. Avogadro” and AOU “Maggiore della Carità”, Novara, Italy

    Pier Paolo Sainaghi, Mattia Bellan, Chiara Cerutti, Daniele Sola, Alessandra Nerviani, Rossella Molinari & Gian Carlo Avanzi

  2. IRCAD (Interdisciplinary Research Center of Autoimmune Diseases), Novara, Italy

    Pier Paolo Sainaghi & Gian Carlo Avanzi

  3. Physical and Rehabilitative Medicine, DMCS Università del Piemonte Orientale “A. Avogadro” and AOU “Maggiore della Carità”, Novara, Italy

    Stefano Carda & Carlo Cisari

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  1. Pier Paolo Sainaghi
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  2. Mattia Bellan
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  4. Chiara Cerutti
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  9. Gian Carlo Avanzi
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Correspondence to Pier Paolo Sainaghi.

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Sainaghi, P.P., Bellan, M., Carda, S. et al. Hypovitaminosis D and response to cholecalciferol supplementation in patients with autoimmune and non-autoimmune rheumatic diseases. Rheumatol Int 32, 3365–3372 (2012). https://doi.org/10.1007/s00296-011-2170-x

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  • DOI: https://doi.org/10.1007/s00296-011-2170-x

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