THE LEVEL OF VITAMIN D IN MEN WITH ANKYLOSING SPONDYLITIS, THE RELATIONSHIP WITH THE COURSE OF THE DISEASE AND THE STRUCTURAL AND FUNCTIONAL STATE OF BONE TISSUE

Shevchuk S.V.¹, Pavliuk O.M.², Shevchuk O.V. ², Marynych L.I.², Denyshchych L.P.²

• ¹Scientific Research Institute of Invalid Rehabilitation of M.I. Pyrogov Vinnytsya National Medical University
• ²M.I. Pirogov Vinnytsia National Medical University

Summary. Study objective — to determine the levels of vitamin D in patients with ankylosing spondylitis (AS) of the Podolsk region of Ukraine and to assess their relationship with the structural and functional state of bone tissue and the course of the disease. Materials and methods. 81 people with AS, average age 41.0±0.1 years, disease duration 9.0±0.6 years were examined. The diagnosis of AS was established on the basis of ASAS 2009 criteria. Disease activity and the degree of functional disorders were determined by BASDAI, ASDAS-CRB and BASFI functional index. Laboratory tests included determination of C-reactive protein (CRP), markers of bone synthesis (osteocalcin, PINP) and vitamin D. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Results. In men with AS vitamin D deficiency was detected in 35 (43.2%), insufficient levels were found in 25 (30.9%) patients and in 21 (25.9%) patients the level of 25(ОН)D was within the normal range. It is shown that in the spring the share of patients with vitamin D deficiency is the highest (61.8%), winter and summer periods did not differ significantly in vitamin D levels. Decreased BMD was associated with 25(OH)D deficiency, as indicated by the accumulation persons with severe vitamin deficiency (61.5%) in the group of patients with osteoporosis. It was also found that levels of 25(OH)D were closely associated with a probable decrease in markers of bone synthesis (osteocalcin, PINP), high activity of the inflammatory (CRP, ASDAS-CRP, BASDAI) process and had no relationship with the age of patients, disease duration and body mass index. Conclusions. In men with AS with a high frequency (43,2%) there is a deficiency of vitamin D, it is more marked in the spring period and is closely associated with low BMD, high dose of glucocorticoids, high disease activity and severe functional disorders, but does not depend on age, duration of the disease and body mass index.