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Prevalence of and factors associated with vitamin D deficiency in 4,793 Japanese patients with rheumatoid arthritis

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Abstract

To determine the prevalence of vitamin D deficiency and associations with clinical characteristics in Japanese patients with rheumatoid arthritis (RA), serum 25(OH)D levels, laboratory data, and clinical data were obtained from 4,793 patients with RA (4,075 women, 718 men, mean age 59.7 years) who participated in the Institute of Rheumatology Rheumatoid Arthritis observational cohort study in April and May of 2011. Serum vitamin D levels were evaluated using a radioimmunoassay. We defined vitamin D deficiency as <20 ng/mL and severe deficiency as <10 ng/mL. Associations of vitamin D deficiency with patient characteristics were examined using multivariate logistic regression. Among all patients, the mean (SD) serum 25(OH)D level was 16.9 ng/mL (6.1), and the prevalence of vitamin D deficiency and severe deficiency were 71.8 and 11.5 %, respectively. In multivariate analysis, female gender, younger age, high Japanese version of health assessment questionnaire (HAQ) disability score, low serum total protein levels, low serum total cholesterol levels, high serum alkaline phosphate (ALP) levels, and non-steroidal anti-inflammatory drug (NSAID) use were significantly associated with vitamin D deficiency (P < 0.01). Vitamin D deficiency appears to be common in Japanese patients with RA, as previously reported for patients of other ethnicities. Female gender, younger age, high HAQ disability score, low serum levels of total protein and total cholesterol, high serum ALP levels, and NSAID use appear to be associated with vitamin D deficiency in Japanese patients with RA.

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Acknowledgments

We thank all members of the Institute of Rheumatology, Tokyo Women’s Medical University for the successful management of the IORRA cohort and Drs. Tatsuhiko Kuroda, Naoko Tsugawa, and R. L. Wilder for their useful suggestions. This work was supported in part by a grant from the Japan Osteoporosis Society (Dr. Furuya). The IORRA cohort was supported by non-restricted research grants from 40 pharmaceutical companies: Abbott Japan Co., Ltd.; Asahi Kasei Kuraray Medical Co., Ltd.; Asahi Kasei Pharma Corporation; Astellas Pharma Inc.; AstraZeneca K.K.; Bristol-Myers Squibb; Chugai Pharmaceutical Co., Ltd.; Daiichi Fine Chemical Co., Ltd.; Daiichi Sankyo Co., Ltd.; Dainippon Sumitomo Pharma Co., Ltd.; Eisai Co., Ltd.; GlaxoSmithKline K.K.; Hisamitsu Pharmaceutical Co., Inc.; Janssen Pharmaceutical K.K.; Japan Tobacco Inc.; Kaken Pharmaceutical Co., Ltd.; Kissei Pharmaceutical Co., Ltd.; Kowa Pharmaceutical Co., Ltd.; Maruho Co., Ltd.; Mitsubishi Chemical Medience Corporation; Mitsubishi Tanabe Pharma Corporation; Mochida Pharmaceutical Co., Ltd.; MSD K.K.; Mundipharma K.K., Nippon Chemiphar Co., Ltd.; Nippon Shinyaku Co., Ltd.; Novartis Pharma K.K.; Otsuka Pharmaceutical Co., Ltd.; Pfizer Japan Inc.; Sanofi-Aventis K.K.; Santen Pharmaceutical Co., Ltd.; Sanwa Kagaku Kenkyusho Co., Ltd.; Sekisui Medical Co., Ltd.; Shionogi & Co., Ltd.; Taisho Toyama Pharmaceutical Co., Ltd.; Takeda Pharmaceutical Company Limited; Teijin Pharma Limited; Torii Pharmaceutical Co., Ltd.; Toyama Chemical Co., Ltd.; UCB Japan Co., Ltd.; Wyeth K.K.; and Zeria Pharmaceutical Co., Ltd.

Conflict of interest

HY has received a research grant from: Chugai Pharmaceutical Co., Ltd., Astellas Pharma Inc.; Wyeth K.K., Daiichi Sankyo Co., Ltd.; Banyu Pharmaceutical Co., Ltd.; Mitsubishi Tanabe Pharma Corporation; Abbott Japan Co., Ltd.; Eisai Co., Ltd.; Santen Pharmaceutical Co., Ltd.; Taishotoyama Pharmaceutical Co., Ltd.; Takeda Pharmaceutical Company Limited; Kissei Pharmaceutical Co., Ltd.; and Janssen Pharmaceutical K.K. and a lecture fee and/or consulting fee from: Abbott, Eisai Co., Ltd.; Takeda Pharmaceutical Company Limited; Mitsubishi Tanabe Pharma Corporation; Janssen Pharmaceutical K.K.; Hoffmann-La Roche; and Chugai Pharmaceutical Co., Ltd. The other authors have no conflicts of interest to state.

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Authors and Affiliations

  1. Institute of Rheumatology, Tokyo Women’s Medical University, 10-22 Kawada-cho, Shinjuku-ku, 162-0054, Tokyo, Japan

    Takefumi Furuya, Eiichi Tanaka, Ayako Nakajima, Atsuo Taniguchi, Shigeki Momohara & Hisashi Yamanaka

  2. Department of Clinical Research and Development, National Center for Geriatrics and Gerontology, 35 Gengo, Morioka-machi, Obu City, 474-8511, Aichi, Japan

    Takayuki Hosoi

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  1. Takefumi Furuya
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  2. Takayuki Hosoi
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  3. Eiichi Tanaka
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  4. Ayako Nakajima
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  5. Atsuo Taniguchi
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  6. Shigeki Momohara
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  7. Hisashi Yamanaka
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Correspondence to Takefumi Furuya.

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Furuya, T., Hosoi, T., Tanaka, E. et al. Prevalence of and factors associated with vitamin D deficiency in 4,793 Japanese patients with rheumatoid arthritis. Clin Rheumatol 32, 1081–1087 (2013). https://doi.org/10.1007/s10067-013-2216-4

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  • DOI: https://doi.org/10.1007/s10067-013-2216-4

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