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Vitamin D Status in Rheumatoid Arthritis: Inflammation, Arterial Stiffness and Circulating Progenitor Cell Number.

Lo Gullo A, Mandraffino G, Bagnato G, Aragona CO, Imbalzano E, D'Ascola A, Rotondo F, Cinquegrani A, Mormina E, Saitta C, Versace AG, Sardo MA, Lo Gullo R, Loddo S, Saitta A - PLoS ONE (2015)

Bottom Line: CD34+ count and vitamin D levels were lower in RA patients as compared to controls, while fibrinogen, CRP, PWV and cIMT were higher in RA patients.RA patients with moderate disease activity presented with low vitamin D levels, low CD34+ cell count, increased PWV and cIMT; we found that vitamin D deficiency is associated to CD34+ cell reduction in peripheral blood, and with fibrinogen levels.This suggests that vitamin D might contribute to endothelial homeostasis in patients with RA.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

ABSTRACT

Background and aims: Suboptimal vitamin D status was recently acknowledged as an independent predictor of cardiovascular diseases and all-cause mortality in several clinical settings, and its serum levels are commonly reduced in Rheumatoid Arthritis (RA). Patients affected by RA present accelerated atherosclerosis and increased cardiovascular morbidity and mortality with respect to the general population. In RA, it has been reported an impairment of the number and the activity of circulating proangiogenic haematopoietic cells (PHCs), including CD34+, that may play a role in endothelial homeostasis. The purpose of the study is to investigate the association between vitamin D levels and PHCs, inflammatory markers, and arterial stiffening in patients with RA.

Methods and results: CD34+ cells were isolated from 27 RA patients and 41 controls. Vitamin D levels, C-reactive protein (CRP), fibrinogen, pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) were also evaluated. CD34+ count and vitamin D levels were lower in RA patients as compared to controls, while fibrinogen, CRP, PWV and cIMT were higher in RA patients. CD34+ cell number appeared to be associated with vitamin D levels, and negatively correlated to fibrinogen and early atherosclerosis markers (PWV and cIMT); vitamin D levels appear also to be inversely associated to fibrinogen.

Conclusions: RA patients with moderate disease activity presented with low vitamin D levels, low CD34+ cell count, increased PWV and cIMT; we found that vitamin D deficiency is associated to CD34+ cell reduction in peripheral blood, and with fibrinogen levels. This suggests that vitamin D might contribute to endothelial homeostasis in patients with RA.

No MeSH data available.


Related in: MedlinePlus

Box and whiskers plots for CD34+ cell number (a) and Vitamin D levels (b) in controls (C) and RA patients (RA).*p<0.01 vs controls, **p<0.001 vs controls. Solid horizontal lines = median values; error bars = 95% Confidence intervals; Shaded area = Interquartile range.
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pone.0134602.g003: Box and whiskers plots for CD34+ cell number (a) and Vitamin D levels (b) in controls (C) and RA patients (RA).*p<0.01 vs controls, **p<0.001 vs controls. Solid horizontal lines = median values; error bars = 95% Confidence intervals; Shaded area = Interquartile range.

Mentions: Table 1 shows the baseline characteristics of the study groups. No difference was detected as regards age, BMI, gender, blood pressure, glucose, lipid profile. Fibrinogen, PWV and also cIMT values was significantly higher in RA patients compared to controls (p<0.001) as was CRP (p<0.05); moreover, cIMT was on average above 0.9 mm, considered the upper reference limit for preclinical atherosclerosis according to ESH-ESC guidelines [35]. Vitamin D levels and CD34+ cells were significant lower respect to controls (both p<0.001). The disease activity score (DAS) and the duration of disease are also reported in Table 1. Eighteen of 27 patients with RA were both RF and aCCP positive, nine were only RF positive. In RA, vitamin D insufficiency was found in 10 patients, vitamin D deficiency in 7 patients and sufficiency levels of vitamin D in 10 patients. Fig 3 shows box and whiskers plots for CD34+ cell number (a) and vitamin D levels (b), in controls and RA patients. Fig 4 shows box and whiskers plots for CD34+ cell number in RA patients according to have vitamin D deficiency (D), insufficiency (I) or optimal plasma levels (O).


Vitamin D Status in Rheumatoid Arthritis: Inflammation, Arterial Stiffness and Circulating Progenitor Cell Number.

Lo Gullo A, Mandraffino G, Bagnato G, Aragona CO, Imbalzano E, D'Ascola A, Rotondo F, Cinquegrani A, Mormina E, Saitta C, Versace AG, Sardo MA, Lo Gullo R, Loddo S, Saitta A - PLoS ONE (2015)

Box and whiskers plots for CD34+ cell number (a) and Vitamin D levels (b) in controls (C) and RA patients (RA).*p<0.01 vs controls, **p<0.001 vs controls. Solid horizontal lines = median values; error bars = 95% Confidence intervals; Shaded area = Interquartile range.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4524708&req=5

pone.0134602.g003: Box and whiskers plots for CD34+ cell number (a) and Vitamin D levels (b) in controls (C) and RA patients (RA).*p<0.01 vs controls, **p<0.001 vs controls. Solid horizontal lines = median values; error bars = 95% Confidence intervals; Shaded area = Interquartile range.
Mentions: Table 1 shows the baseline characteristics of the study groups. No difference was detected as regards age, BMI, gender, blood pressure, glucose, lipid profile. Fibrinogen, PWV and also cIMT values was significantly higher in RA patients compared to controls (p<0.001) as was CRP (p<0.05); moreover, cIMT was on average above 0.9 mm, considered the upper reference limit for preclinical atherosclerosis according to ESH-ESC guidelines [35]. Vitamin D levels and CD34+ cells were significant lower respect to controls (both p<0.001). The disease activity score (DAS) and the duration of disease are also reported in Table 1. Eighteen of 27 patients with RA were both RF and aCCP positive, nine were only RF positive. In RA, vitamin D insufficiency was found in 10 patients, vitamin D deficiency in 7 patients and sufficiency levels of vitamin D in 10 patients. Fig 3 shows box and whiskers plots for CD34+ cell number (a) and vitamin D levels (b), in controls and RA patients. Fig 4 shows box and whiskers plots for CD34+ cell number in RA patients according to have vitamin D deficiency (D), insufficiency (I) or optimal plasma levels (O).

Bottom Line: CD34+ count and vitamin D levels were lower in RA patients as compared to controls, while fibrinogen, CRP, PWV and cIMT were higher in RA patients.RA patients with moderate disease activity presented with low vitamin D levels, low CD34+ cell count, increased PWV and cIMT; we found that vitamin D deficiency is associated to CD34+ cell reduction in peripheral blood, and with fibrinogen levels.This suggests that vitamin D might contribute to endothelial homeostasis in patients with RA.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.

ABSTRACT

Background and aims: Suboptimal vitamin D status was recently acknowledged as an independent predictor of cardiovascular diseases and all-cause mortality in several clinical settings, and its serum levels are commonly reduced in Rheumatoid Arthritis (RA). Patients affected by RA present accelerated atherosclerosis and increased cardiovascular morbidity and mortality with respect to the general population. In RA, it has been reported an impairment of the number and the activity of circulating proangiogenic haematopoietic cells (PHCs), including CD34+, that may play a role in endothelial homeostasis. The purpose of the study is to investigate the association between vitamin D levels and PHCs, inflammatory markers, and arterial stiffening in patients with RA.

Methods and results: CD34+ cells were isolated from 27 RA patients and 41 controls. Vitamin D levels, C-reactive protein (CRP), fibrinogen, pulse wave velocity (PWV), and carotid intima-media thickness (cIMT) were also evaluated. CD34+ count and vitamin D levels were lower in RA patients as compared to controls, while fibrinogen, CRP, PWV and cIMT were higher in RA patients. CD34+ cell number appeared to be associated with vitamin D levels, and negatively correlated to fibrinogen and early atherosclerosis markers (PWV and cIMT); vitamin D levels appear also to be inversely associated to fibrinogen.

Conclusions: RA patients with moderate disease activity presented with low vitamin D levels, low CD34+ cell count, increased PWV and cIMT; we found that vitamin D deficiency is associated to CD34+ cell reduction in peripheral blood, and with fibrinogen levels. This suggests that vitamin D might contribute to endothelial homeostasis in patients with RA.

No MeSH data available.


Related in: MedlinePlus