25-hydroxyvitamin-d-2 and Arthritis--Juvenile

In addition to its important metabolic activities, vitamin D also contributes to the regulation of the immune system. The aim of this study was to assess the relationship between hypovitaminosis D and disease activity in Moroccan children with juvenile idiopathic arthritis (JIA).. In this cross-sectional study, forty children with JIA were included, all having been diagnosed according to the classification criteria of International League of Associations for Rheumatology (ILAR). The children underwent anthropometric assessment and clinical evaluation. Disease activity was measured using the Disease Activity Score in 28 joints (DAS28) for polyarticular and oligoarticular JIA and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for enthesitis-related arthritis. Serum 25-hydroxyvitamin [25(OH)D] D2 and D3 were measured using radioimmunoassay (RIA). Hypovitaminosis D was defined as serum 25(OH)D <30 ng/ml.. The average age of participants was 11 years ± 4.23. Hypovitaminosis D was observed in 75% of patients. In univariate analyses, 25(OH)D levels were negatively associated with DAS28 for polyarticular and oligoarticular JIA. No significant relationship was found between 25(OH)D levels and BASDAI for juvenile spondylarthropathy. In multivariate linear regression analysis, no association persisted between 25(OH)D levels and DAS28.. Our study suggested that serum levels of vitamin D were low in Moroccan children with JIA disease. Future studies with a larger population are needed to confirm our results.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Alkaline Phosphatase; Anthropometry; Antirheumatic Agents; Arthritis, Juvenile; Autoimmunity; Calcifediol; Calcium; Child; Comorbidity; Cross-Sectional Studies; Female; Humans; Male; Morocco; Phosphates; Socioeconomic Factors; Surveys and Questionnaires; Vitamin D Deficiency

Topics: 25-Hydroxyvitamin D 2; Adolescent; Arthritis, Juvenile; Bone Density; Child; Child, Preschool; Female; Humans; Male; Osteocalcin; Parathyroid Hormone

Seventy children with juvenile chronic arthritis have had measurements of cortical and trabecular bone density in one or both radii. In 7 children with unilateral disease of one wrist, there was a substantial reduction in growth on the affected side. Trabecular bone density in the distal radius was reduced in the main group of 63 patients compared with controls, and this deficit was appreciably worse if the wrist was clinically affected by disease or if the child was being treated with steroids. Cortical bone density in the midshaft was less affected. Crush fractures of the spine were associated with more prolonged periods of bed rest, steroid therapy, radial trabecular bone density more than 2 standard deviations below normal, and subnormal 25-hydroxycholecalciferol concentrations in the serum. Since steroid therapy is often mandatory the main therapeutic implications are that the more severely affected child often needs vitamin D supplementation in "physiological" dosage, and that early mobilisation and reduction of steroid dosage should be constant aims.

Topics: 25-Hydroxyvitamin D 2; Absorptiometry, Photon; Adolescent; Arthritis, Juvenile; Bone and Bones; Bone Diseases; Child; Chronic Disease; Ergocalciferols; Fractures, Closed; Fractures, Spontaneous; Humans; Organ Size; Spinal Injuries; Steroids