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Vitamin D deficiency is associated with higher disease activity and the risk for uveitis in juvenile idiopathic arthritis - data from a German inception cohort
Authors:Claudia Sengler  Julian Zink  Jens Klotsche  Martina Niewerth  Ina Liedmann  Gerd Horneff  Christoph Kessel  Gerd Ganser  Angelika Thon  Johannes-Peter Haas  Anton Hospach  Frank Weller-Heinemann  Arnd Heiligenhaus  Dirk Foell  Angela Zink  Kirsten Minden
Institution:1.German Rheumatism Research Center, a Leibniz Institute,Berlin,Germany;2.Institute for Social Medicine, Epidemiology and Health Economics,Charité Universit?tsmedizin Berlin,Berlin,Germany;3.Center for General Pediatrics and Neonatology, Asklepios Klinik Sankt Augustin,Sankt Augustin,Germany;4.University hospital Cologne,Cologne,Germany;5.Department of Pediatric Rheumatology and Immunology,University of Münster,Münster,Germany;6.Clinic of Pediatric Rheumatology,St. Josef-Stift Hospital,Sendenhorst,Germany;7.Department of Pediatric Pneumology, Allergology and Neonatology,Children’s Hospital, Medical School,Hanover,Germany;8.German Center for Pediatric and Adolescent Rheumatology,Garmisch-Partenkirchen,Germany;9.Olgahospital Kinderklinik,Stuttgart,Germany;10.Prof.-Hess-Kinderklinik,Bremen,Germany;11.Department of Ophthalmology and Ophtha-Lab at St. Franziskus Hospital,Muenster,Germany;12.University of Duisburg-Essen,Essen,Germany;13.Department of Rheumatology and Clinical Immunology,Charité Universit?tsmedizin Berlin,Berlin,Germany
Abstract:

Objective

The objective was to evaluate the 25(OH) vitamin D (25(OH)D) status of patients with juvenile idiopathic arthritis (JIA) and determine whether the 25(OH)D level is associated with disease activity and the course of JIA.

Methods

Patients ≤?16?years of age with recently diagnosed JIA (<?12?months) were enrolled in the inception cohort of patients with newly diagnosed JIA (ICON), an ongoing prospective observational, controlled multicenter study started in 2010. Clinical and laboratory parameters were ascertained quarterly during the first year and half-yearly thereafter.Of the 954 enrolled patients, 360 patients with two blood samples taken during the first 2?years after inclusion and with follow up of 3?years were selected. The serum 25(OH)D levels were determined and compared with those of subjects from the general population after matching for age, sex, migration status and the month of blood-drawing.

Results

Nearly half of the patients had a deficient 25(OH)D level (<?20?ng/ml) in the first serum sample and a quarter had a deficient level in both samples. Disease activity and the risk of developing JIA-associated uveitis were inversely correlated with the 25(OH)D level (β?=???0.20, 95% CI ??0.37; 0.03, hazard ratio 0.95, 95% CI 0.91; 0.99, respectively).

Conclusion

In this study, 25(OH)D deficiency was common and associated with higher disease activity and risk of developing JIA-associated uveitis. Further studies are needed to substantiate these results and determine whether correcting 25(OH)D deficiency is beneficial in JIA.
Keywords:
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