Prevalence of Vitamin D Deficiency in Patients Treated for Juvenile Idiopathic Arthritis and Potential Role of Methotrexate: A Preliminary Study

被引:8
作者
Stawicki, Maciej K. [1 ]
Goralczyk, Adrian [1 ]
Mlynczyk, Justyna [2 ]
Kondratiuk, Anna [1 ]
Konstantynowicz, Jerzy [1 ]
机构
[1] Med Univ Bialystok, Dept Pediat Rheumatol Immunol & Metab Bone Dis, Waszyngtona St 17, PL-15274 Bialystok, Poland
[2] Hosp Minist Adm & Internal Affairs Bialystok, Dept Orthopaed & Traumatol, Fabryczna St 27, PL-15471 Bialystok, Poland
关键词
juvenile idiopathic arthritis; vitamin D; calcium; phosphate metabolism; methotrexate; children; 25-HYDROXYVITAMIN D LEVELS; OF-RHEUMATOLOGY RECOMMENDATIONS; DISEASE-ACTIVITY; MINERAL METABOLISM; BONE METABOLISM; YOUNG-ADULTS; CHILDREN; HEALTH; DETERMINANTS; ASSOCIATIONS;
D O I
10.3390/nu14081645
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background: Vitamin D deficiency is reported in rheumatological diseases in adults. The aim was to evaluate the prevalence of vitamin D deficiency in children with juvenile idiopathic arthritis (JIA) and to investigate potential correlations between vitamin D status and clinical factors, laboratory traits, and medical treatment, including methotrexate (MTX) and glucocorticoids (GCs). Methods: In 189 patients aged 3-17.7 years, with JIA in the stable stage of the disease, anthropometry, clinical status, serum 25-hydroxyvitamin D [25(OH)D], calcium (Ca), phosphate (PO4), total alkaline phosphatase (ALP), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were assessed. Results: Median 25(OH)D level was 15.00 ng/mL, interquartile range (IQR) 12.00 ng/mL. Vitamin D deficiency was found in 67.2% and was independent of sex, disease manifestation, and CRP, ESR, ALP, or PO4 levels. Higher doses of MTX corresponded with lower 25(OH)D levels using both univariate and multivariate models (p < 0.05). No such trend was found for GCs treatment. Serum Ca was lower in patients treated with GCs (p = 0.004), MTX (p = 0.03), and combined GCs/MTX (p = 0.034). Conclusions: JIA patients are vitamin D depleted independently of disease activity or inflammatory markers. MTX therapy may be an iatrogenic factor leading to inadequate 25(OH)D levels. Vitamin D supplementation should be considered in all children with JIA, particularly those receiving long-term MTX therapy.
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页数:9
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