Muscle inflammation 17X more probable if vitamin D deficient – Feb 2013

Low serum levels of vitamin D in idiopathic inflammatory myopathies

Ann Rheum Dis 2013;72:512-516 doi:10.1136/annrheumdis-2012-201849; Editor's Choice
Payam Azali 1, payam.azali at ds.se
Sevim Barbasso Helmers2,
Ingrid Kockum3,
Tomas Olsson3,
Lars Alfredsson2,
Peter J Charles4,
Karin Piehl Aulin1,
Ingrid E Lundberg5
1Rheumatology Unit, Danderyd's Hospital, Karolinska Institutet, Stockholm, Sweden
2Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3Neuroimmunology, Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
4Department of Translational Research, Kennedy Institute, London, UK
5Rheumatology Unit, Department of Medicine, Karolinska University Hospital, Solna, Karolinska Institutet, Stockholm, Sweden
Accepted 21 August 2012; Published Online First 19 September 2012

Objectives To evaluate serum levels of 25(OH) vitamin D in patients with idiopathic inflammatory myopathies (IIM) (polymyositis (PM), dermatomyosistis (DM), inclusion body myositis (IBM) and juvenile DM (JDM)) and to compare these with healthy controls.

Methods Serum samples from 149 patients with IIM and 290 healthy controls matched for gender and the month of blood sampling were analysed for 25(OH) vitamin D. ORs for vitamin D classes with 95% CI were calculated using a matched (conditional) logistic regression model. Groups were compared by the Kruskal–Wallis test and p values <0.05 were considered significant.

Results Patients with IIM had significantly lower serum levels of 25(OH) vitamin D than healthy controls (median 39 (10–168) nmol/l vs 68 (19–197) nmol/l; p=0.0001). There was no significant difference in vitamin D levels between the myositis subgroups. When vitamin D levels were subclassified into deficient (<50 nmol/l), insufficient (50–74 nmol/l) and normal (≥75 nmol/l), most of the patients with PM (68%), DM (65%) and IBM (53%) had deficient levels compared with only 60 (21%) healthy individuals.
In patients with IIM the OR for deficient versus normal was 17.7 (95% CI 8.1 to 38.6) and the OR for insufficient versus normal was 2.4 (95% CI 1.2 to 4.7).

Conclusions Low serum levels of vitamin D were found in most patients with IIM and may confer a risk factor for developing adult myositis, similar to some other autoimmune diseases.

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