Regional differences of vitamin D deficiency in rheumatoid arthritis patients in Italy

  • M. Rossini | Rheumatology Unit, University of Verona, Italy.
  • G. D'Avola Rheumatology Unit, AUSL 3, Catania, Italy.
  • M. Muratore Rheumatology Unit, Galateo San Cesario Hospital, Lecce, Italy.
  • N. Malavolta Rheumatology Unit, University of Bologna, Italy.
  • F. Silveri Rheumatology Unit, University of Ancona, Jesi (AN), Italy.
  • G. Bianchi Rheumatology Unit, La Colletta Hospital, Arenzano (GE), Italy.
  • B. Frediani Rheumatology Unit, University of Siena, Italy.
  • G. Minisola Rheumatology Unit, San Camillo Hospital, Roma, Italy.
  • M. L. Sorgi Rheumatology Unit, University “La Sapienza”, Roma, Italy.
  • M. Varenna Rheumatology Unit, Gaetano Pini Orthopedic Institute, Milano, Italy.
  • R. Foti Rheumatology Unit, Vittorio Emanuele Hospital, Catania, Italy.
  • G. Tartarelli Rheumatology Unit, Hospital of Massa (MS), Italy.
  • G. Orsolini Rheumatology Unit, University of Verona, Italy.
  • S. Adami Rheumatology Unit, University of Verona, Italy.


Vitamin D deficiency is very common in patients with rheumatoid arthritis (RA). Aim of this study was to evaluate the prevalence of vitamin D deficiency among the different Italian regions and whether these variations are associated with different severity of the disease. The study includes 581 consecutive RA patients (464 women), not taking vitamin D supplements, from 22 Italian rheumatology centres uniformly distributed across Italy. Together with parameters of disease activity (disease activity score 28), functional impairment (activities of daily living and health assessment questionnaire disability index) and mean sun exposure time, all patients had serum 25-hydroxyvitamin D (25OHD) measured in a centralized laboratory. Vitamin D deficiency (25OHD level <20 ng/mL) was very frequent among RA patients; its prevalence was 60%, 52% and 38% in southern, central and northern Italy, respectively. Mean disease activity and disability scores were worse in southern regions of Italy. These scores were inversely related to 25OHD levels and this correlation remained statistically significant after adjusting for both body mass index (BMI) and sun exposure time. However, disease severity remained significantly higher in southern regions versus central-northern Italy after adjustment also for serum 25OHD levels, age and BMI. In RA Italian patients there are significant regional differences in the prevalence of vitamin D deficiency explained by different BMI, and sun exposure time, and inversely associated with disease activity and disability scores.



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Rheumatoid arthritis, Vitamin D, Disease activity, Disability, Body mass index.
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How to Cite
Rossini, M., D’Avola, G., Muratore, M., Malavolta, N., Silveri, F., Bianchi, G., Frediani, B., Minisola, G., Sorgi, M. L., Varenna, M., Foti, R., Tartarelli, G., Orsolini, G., & Adami, S. (2013). Regional differences of vitamin D deficiency in rheumatoid arthritis patients in Italy. Reumatismo, 65(3), 113-120.

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