Objectives: To assess the effect of vitamin D supplementation on bone mineral density (BMD) in rheumatoid arthritis (RA) patients with osteoporosis and determine whether supplementation of more than 800 IU/day, which is the currently recommended dose, is beneficial. Methods: RA patients with osteoporosis who received bisphosphonate were included. Patients were classified into four groups according to the dose of vitamin D supplementation (0, 400, 800, and ≥1,000 IU/day). Multivariable linear regression models were performed to evaluate the effect of each dose of vitamin D supplementation on 1-year % change of BMD. Results: In total, 187 RA patients with osteoporosis were included. In the multivariate model adjusted for potential confounders, patients receiving vitamin D supplementation had a significantly higher increase in 1-year % change in lumbar spine BMD (400 IU/day: β=2.51 [95% CI: 0.04–4.99], 800 IU/day: β=2.90 [95% CI: 0.47–5.33], and ≥1,000 IU/day: β=6.01 [95% CI: 3.71–8.32]) and femoral neck BMD (400 IU/day: β=3.88 [95% CI: 1.83–5.94], 800 IU/day: β=4.30 [95% CI: 2.25–6.35], and ≥1,000 IU/day: β=6.79 [95% CI: 4.87–8.71]) than those not receiving the supplementation. Notably, the ≥1,000 IU/day group had a significantly higher increase in 1-year % change in lumbar spine BMD (β=3.11 [95% CI: 0.86–5.37]) and femoral neck BMD (β=2.50 [95% CI: 0.63–4.36]) than the 800 IU/day group. Conclusion: In RA patients with osteoporosis receiving bisphosphonates, vitamin D supplementation was associated with a higher increase in BMD. This effect was higher in vitamin D supplementation dose of ≥1,000 IU/day than in 800 IU/day.
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机译:目的:评估维生素D补充对类风湿性关节炎(RA)骨质疏松患者骨密度(BMD)对骨质疏松症患者的影响,并确定是否为800多种IU /天,这是目前推荐剂量的补充,是有益的。方法:包括接受双膦酸酯的骨质疏松症的RA患者。根据维生素D补充剂(0,400,800和≥1,000IU /日),患者分为四组。进行多变量的线性回归模型以评估每种剂量维生素D补充对BMD的1岁的效果的影响。结果:总共包括187例骨质疏松症的患者。在调整潜在混淆的多变量模型中,接受维生素D补充的患者在腰椎BMD(400 IU /日:β= 2.51 [95%CI:0.04-4.99],800 IU)中的1岁%变化升高显着提高/日:β= 2.90 [95%CI:0.47-5.33],≥1,000IU /日:β= 6.01 [95%CI:3.71-8.32])和股骨颈部BMD(400 IU /日:β= 3.88 [ 95%CI:1.83-5.94],800 IU /日:β= 4.30 [95%CI:2.25-6.35],≥1,000IU /日:β= 6.79 [95%CI:4.87-8.71])而不是那些收到补充。值得注意的是,≥1,000IU/日组的腰椎BMD的1年%变化≥1,000个IU /日组(β= 3.11 [95%CI:0.86-5.37])和股骨颈BMD(β= 2.50 [95%CI [95%CI [95% :0.63-4.36])比800 IU /日组。结论:在接受双膦酸盐的骨质疏松症患者的RA患者中,维生素D补充剂与BMD的增加有关。维生素D补充剂量≥1,000IU/日的这种效果高于800 IU /天。
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