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Observational Study
. 2018 Dec 13;20(1):276.
doi: 10.1186/s13075-018-1765-y.

Vitamin D deficiency is associated with higher disease activity and the risk for uveitis in juvenile idiopathic arthritis - data from a German inception cohort

Claudia Sengler  1 , Julian Zink  2 , Jens Klotsche  2   3 , Martina Niewerth  2 , Ina Liedmann  2 , Gerd Horneff  4   5 , Christoph Kessel  6 , Gerd Ganser  7 , Angelika Thon  8 , Johannes-Peter Haas  9 , Anton Hospach  10 , Frank Weller-Heinemann  11 , Arnd Heiligenhaus  12   13 , Dirk Foell  6 , Angela Zink  2   14 , Kirsten Minden  2   14
Affiliations
Observational Study

Vitamin D deficiency is associated with higher disease activity and the risk for uveitis in juvenile idiopathic arthritis - data from a German inception cohort

Claudia Sengler et al. Arthritis Res Ther. .

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: Disease activity; Juvenile idiopathic arthritis; Uveitis; Vitamin D.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the ethics committee of the Charité – Universitätsmedizin Berlin. Parents and patients from the age of 8 years gave their informed assent/consent for participation.

Consent for publication

Not applicable.

Competing interests

C Sengler, none; J Zink, none; J Klotsche, none; M Niewerth, none; I Liedmann, none; G Horneff has received honoraria from Novartis, Chugai, Boeringer, Celgene and BMS and research grants from AbbVie, Chugai, MSD, Novartis, Pfizer and Roche; G Ganser, none; A Thon, none; J-P Haas has received research support from Novartis and Pfizer; A Hospach has received consulting fees, speaking fees and/or honoraria from Chugai and Novartis (< US$10,000 each); F Weller-Heinemann, none; A Heiligenhaus has received research grants from Pfizer and Novartis and honoraria from AbbVie, Alimera Sciences, Allergan, MSD Sharp and Dohme, Pfizer, Santen and Xoma; D Foell has received consulting fees, speaking fees and/or honoraria from Chugai-Roche, Sobi, Novartis and Pfizer (< US$10,000 each) and research grants from Novartis and Pfizer; Drs Kessel and Foell have submitted a patent application relating to the use of proinflammatory S100A12 homomultimers in the diagnosis and treatment of inflammatory disorders (WO 2016/178154 A1); A Zink, none; K Minden has received honoraria (< US$10.000) from AbbVie, Biermann, Chugai, Medac and Roche.

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Figures

Fig. 1
Fig. 1
Association between Clinical Juvenile Arthritis Disease Activity Score (cJADAS-10) and 25-hydroxy-vitamin D (25(OH)D) level at first measurement. DMARD, disease-modifying anti-rheumatic drug
Fig. 2
Fig. 2
Proportion of patients with stable deficient or stable sufficient 25-hydroxy-vitamin D (25(OH)D) status who developed uveitis or the extended form of oligoarthritis up to the 3-year follow up
See this image and copyright information in PMC

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