ABSTRACT
Background: Vitamin D is a steroid hormone that affects the expression of
many genes and regulates a wide variety of cell types and organ systems,
including the cardiovascular system. Patients affected by rheumatoid
arthritis (RA) present with accelerated atherosclerosis and increased risk of
cardiovascular disease (CVD). Aim: The aim is to evaluate the impact of
vitamin-D intake on markers of vascular function in patients with RA.
Methods: Forty RA with vitamin-D deficient patients were included and
were supplemented with oral doses of cholecalciferol (50,000 IU) weekly
Egypt. J. of Appl. Sci., 35 (11) 2020 200-219
for 8 weeks. Conventional rheumatoid measures such as DAS-28, RF, CRP
and anti-MCV as well as measures of vascular functions flow-mediated
dilatation (FMD) and circulating endothelial cells (CECs) and serum
adhesion markers ICAM and VCAM were assessed at baseline and 8 weeks
post-treatment. Forty healthy individuals were included as controls. Results:
RA patients showed impaired FMD as compared with controls (4.28% vs
10.10%, p < 0 .05). Significant inverse relationships were detected between
DAS-28 score and both vitamin D and FMD (r=0.437; P=0.001 and
r=0.315; P=0.002 respectively). Vitamin-D intake was associated with
significant improvement in FMD and lower CECs numbers. Intervention
also led to significant favorable effects on inflammatory (CRP and ESR),
rheumatic (RF, anti-MCV) and on circulating adhesion molecules levels
(ICAM and VCAM). Conclusion: The present data indicate that
supplementing RA with VD3 significantly improves vascular functions as
indicated by enhanced FMD through a mechanism that involves regulation
of adhesion molecules and inflammatory mediators.