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Elevated serum 25-hydroxyvitamin D: a potential indicator of remission in Takayasu arteritis patients with normal ESR and CRP levels

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Abstract

Objective

The goal of the present study was to investigate the correlation between serum 25-hydroxyvitamin D [25(OH)D] levels and disease remission in Takayasu arteritis (TAK) patients.

Methods

This retrospective study included 59 patients in the study group and 80 patients in the validation cohort with TAK. After 6 months of therapy, patients were re-evaluated, and serum 25(OH)D levels were compared before and after treatment. Correlations between changes in 25(OH)D levels and changes in disease activity scores (NIH, ITAS2010, ITAS.A) were analyzed. Additionally, a predictive cut-off value for disease remission was determined.

Results

After 6 months of therapy, serum 25(OH)D levels in TAK patients significantly increased compared to baseline [(18.33 ± 7.25)µg/L vs (11.77 ± 4.14) µg/L] (P < 0.001). Positive correlations were observed between the increasing changes in the 25(OH)D level and the decreasing changes in the reduced NIH, ITAS2010, and ITAS.A scores (r = 0.455, P < 0.001; r = 0.495, P < 0.001; and r = 0.352 P = 0.006, respectively). A change of 8.45 µg/L in 25(OH)D level was identified as the predictive cut-off value for TAK remission (sensitivity 54.1%, specificity 90.9%, area under the curve = 0.741). Similarly for patients with normal baseline ESR, sensitivity is 68.0%, specificity is 92.3%, and area under the curve is 0.831, and for patients with normal baseline CRP, sensitivity is 58.3%, specificity is 90.0%, and area under the curve is 0.748. Validation in an additional 80 patients demonstrated a higher remission rate in those with a 25(OH)D level change > 8.45 µg/L.

Conclusion

Serum 25(OH)D levels significantly increased after treatment in TAK patients, and an increase of ≥ 8.45 µg/L was predictive of disease remission, especially in individuals with normal baseline ESR and/or CRP levels.

Key Points

• Following treatment, there was a significant increase in serum 25(OH)D levels among TAK patients.

• The elevated changes in 25(OH)D levels before and after treatment demonstrated a positive correlation with the reduction in disease activity scores.

• In patients with TAK before and after treatment, an elevation in serum 25(OH)D levels exceeding 8.45 µg/L serves as an indicator for disease remission, particularly prominent in individuals with normal baseline ESR and/or CRP levels.

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Data availability

The data used in this manuscript is taken from in-patients of Beijing Anzhen Hospital, Capital Medical University. The data is available via the hospital information system of Beijing Anzhen Hospital. The data used to support the findings of this study are available from the corresponding author upon request.

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Funding

This research was funded by the National Natural Science Foundation of China (grant number 82270427). The funders had no role in the study design, data collection and analysis, decision to publish, or manuscript preparation.

Author information

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Beijing AnZhen Hospital, Capital Medical University, No. 2 Anzhen Rd., Beijing, 100029, China

    Hua Liao, Juan Du, Shiyu Yang & Lili Pan

  2. Beijing AnZhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, the Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China

    Fengjuan Li

  3. Internal Medicine, Our Lady of Lourdes Memorial Hospital, Binghamton, NY, USA

    Guanming Qi

Authors
  1. Hua Liao
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  2. Juan Du
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  3. Fengjuan Li
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  4. Shiyu Yang
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  6. Lili Pan
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Contributions

Hua Liao conceived the study, performed the statistical analysis, and drafted the manuscript. Lili Pan participated in the design of the study and helped revise the manuscript. Fengjuan Li completed the 25(OH)D test, and Hua Liao and Juan Du performed data collection. Shiyu Yang performed RNI and IDI analysis. Guanming Qi helped revise the manuscript. Guanming Qi and Lili Pan contributed equally to the revision of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Guanming Qi or Lili Pan.

Ethics declarations

Ethics approval and consent to participate

The study was conducted by the Declaration of Helsinki, and approved by the Ethics Committee of Beijing AnZhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases [No. 2018056X]. Informed consent was obtained from all subjects involved in the study. Patients were recruited from Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart, Lung, and Blood Vessel Diseases (Beijing, China) during the study period, which was from January 2015 to March 2023. Written informed consent has been obtained from the patients to publish this paper.

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Liao, H., Du, J., Li, F. et al. Elevated serum 25-hydroxyvitamin D: a potential indicator of remission in Takayasu arteritis patients with normal ESR and CRP levels. Clin Rheumatol (2024). https://doi.org/10.1007/s10067-024-06957-w

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  • DOI: https://doi.org/10.1007/s10067-024-06957-w

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