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. 2022 Jul 26:10:915943.
doi: 10.3389/fped.2022.915943. eCollection 2022.

Vitamin D Status Among Children With Juvenile Idiopathic Arthritis: A Multicenter Prospective, Non-randomized, Comparative Study

Elena I Kondratyeva  1   2 , Nuriniso D Odinaeva  2 , Leonid Ya Klimov  3 , Nadeshda S Podchernyaeva  4 , Natalya I Ilenkova  5 , Svetlana V Dolbnya  3 , Elena K Zhekaite  1   2 , Victoria A Kuryaninova  3 , Yuliya V Kotova  2 , Margarita I Tikhaya  4 , Elena P Shitkovskaya  5 , Liubov V Bychina  5 , Tamara G Drepa  3 , Aisa E Zodbinova  1 , Yuliya L Melyanovskaya  1   2 , Nika V Petrova  1 , Elena V Loshkova  2 , Sergei I Kutsev  1
Affiliations

Vitamin D Status Among Children With Juvenile Idiopathic Arthritis: A Multicenter Prospective, Non-randomized, Comparative Study

Elena I Kondratyeva et al. Front Pediatr. .

Abstract

Background: Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease characterized by destructive and inflammatory damage to the joints. The aim in this study was to compare vitamin D levels between children and adolescents, 1-18 years of age, with juvenile idiopathic arthritis (JIA) and a health control group of peers. We considered effects of endogenous, exogenous, and genetic factors on measured differences in vitamin D levels among children with JIA.

Methods: Our findings are based on a study sample of 150 patients with various variants of JIA and 277 healthy children. The blood level of vitamin D was assessed by calcidiol level. The following factors were included in our analysis: age and sex; level of insolation in three regions of country (center, south, north); assessment of dietary intake of vitamin D; effect of prophylactic doses of cholecalciferol; a relationship between the TaqI, FokI, and BsmI polymorphisms of the VDR gene and serum 25(OH)D concentration.

Results: We identified a high frequency of low vitamin D among children with JIA, prevalence of 66%, with the medial level of vitamin D being within the range of "insufficient" vitamin D. We also show that the dietary intake of vitamin D by children with JIA is well below expected norms, and that prophylactic doses of vitamin D supplementation (cholecalciferol) at a dose of 500-1,000 IU/day and 1,500-2,000 IU/day do not meet the vitamin D needs of children with JIA. Of importance, we show that vitamin D levels among children with JIA are not affected by clinical therapies to manage the disease nor by the present of VDR genetic variants.

Conclusion: Prophylactic administration of cholecalciferol and season of year play a determining role in the development of vitamin D deficiency and insufficiency.

Keywords: VDR gene; genotypes; juvenile idiopathic arthritis; seasons of the year; vitamin D deficiency.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict ofinterest.

Figures

Figure 1
Figure 1
Comparison of the level of vitamin D (serum calcidiol, ng/mL) between the JIA and control group by geographical region included in the analysis.
Figure 2
Figure 2
Calcidiol (25(OH)D) level (ng/mL) for the JIA and control groups for each season.
Figure 3
Figure 3
Comparison of the distribution of vitamin D status among the JIA and control groups for each season.
Figure 4
Figure 4
Distribution of vitamin D status as a function of the dose of cholecalciferol supplementation.*p < 0.001, comparison between the JIA and control group, calculated using Pearson's χ2. **p < 0.05, comparison between the JIA and control group, calculated using Fisher's exact test.
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