Prevalence of hypovitaminosis D in Indo-Asian patients attending a rheumatology clinic.

This study was performed to determine the prevalence of hypovitaminosis D (HD) and hypovitaminosis D associated with secondary hyperparathyroidism (HD-SHPT) among Indo-Asians attending rheumatology clinics in Wolverhampton. A cross-sectional survey of 98 clinic attenders and 36 normal controls subjects was undertaken. The groups were matched for age, gender, and body mass index. There was a high prevalence of vegetarianism, and milk consumption was low in both groups. Clinical scores for musculoskeletal pain, gait, and muscle strength were all significantly worse in clinic attenders (p < 0.001). Comparing clinic attenders with controls, 25-OH-vitamin D levels were 6.6 +/- 3.9 vs. 8.2 +/- 4.8 microg/L (p < 0.01) and the prevalence of HD (<8 microg/L) was 78% vs. 58% (p < 0.05), but neither parathyroid hormone levels (53 +/- 60 vs. 50 +/- 18 ng/L, n.s.) nor HD-SHPT prevalence (22% vs. 33%, n.s.) were significantly different. Routine biochemical tests were not discriminant, but none of the controls and 10 of 98 (10%) clinic attenders had elevated alkaline phosphatase levels: 6 with HD and 3 with HD-SHPT. Vitamin D deficiency has an extremely high prevalence among Indo-Asians in the U.K., particularly in those attending rheumatology clinics. Detection of HD and HD-SHPT is only possible using measurements of 25-OH-vitamin D and PTH.

Relationship of hypovitaminosis D and secondary hyperparathyroidism with bone mineral density among UK resident Indo-Asians.

BACKGROUND: There is a high prevalence of vitamin D deficiency in UK resident Indo-Asians and this may be complicated by secondary hyperparathyroidism. OBJECTIVE: To investigate the relationship between these conditions and bone mineral density (BMD) in Indo-Asian rheumatology patients. METHODS: 110 Indo-Asian patients presenting to a general rheumatology clinic were selected for the study, of whom 77 were vitamin D deficient (HD), and 33 also had associated secondary hyperparathyroidism (HD-SHPT). BMD measurements at the femoral neck (FN), lumbar spine (LS), distal radius (DR), and radius 33% were obtained. T and Z scores were used in the evaluation of the dual energy x ray absorptiometry findings. The Mann-Whitney U test and chi(2) tests were used in the statistical analysis. RESULTS: The patients with HD-SHPT had significantly lower serum 25-OH-vitamin D, higher serum alkaline phosphatase, and lower calcium levels than the HD group. Both T and Z scores failed to show any significant difference between the groups in the LS, but patients with HD-SHPT compared with those with HD had significantly lower FN T scores (-1.05 (1.47) v 0.28 (1.22), p=0.003), FN Z scores (-0.45 (1.27) v 0.26 (0.96), p=0.001), DR T scores (-1.83 (1.82) v -0.44 (1.77), p<0.001), DR Z scores (-1.25 (1.44) v -0.08 (1.6), p=0.001), radius 33% T scores (-1.65 (1.66) v -0.79 (1.21), p=0.008), and radius 33% Z scores (-1.07 (1.28) v -0.44 (1.1), p=0.017). CONCLUSION: Hypovitaminosis D complicated by secondary hyperparathyroidism is associated with significantly decreased bone mineral density.

Prevalence of atopy in rheumatoid arthritis in Sivas, Turkey. A prospective clinical study.

Assumed mutual antagonism of T-helper cell (Th)1 and Th2 diseases suggests that the prevalence of atopy should be decreased in rheumatoid arthritis (RA). We tried to determine that prevalence. Sixty-two patients with RA and 61 with osteoarthritis (control group) were included in the study. A questionnaire was used concerning mainly the symptoms of atopy. Skin prick tests, pulmonary function tests, chest X-rays, immunoglobulin E levels, and eosinophil counts were obtained. The prevalences of asthma, hay fever, and eczema in the RA group were 3.2%, 14.5%, and 1.6%, respectively. In the control group, they were 6.5%, 22%, and 6.5%, respectively. There was no significant difference between groups. There was also no significant difference between immunoglobulin E levels. Eosinophil counts were higher in the control group, however these values were within the normal range. Skin prick tests were obtained in seven RA patients, and eight controls revealed increased positivity. The prevalence of atopy in rheumatoid arthritis was not different from that in the general population. Our study results cannot support the concept of Th1/Th2 mutual antagonism.