Background. Vitamin D is able to regulate the activity of immune system in vitro; whether this action has some relevance in vivo is still a matter of debate. Aim. To investigate the potential role of vitamin D in the pathogenesis and in the management of Rheumatoid Arthritis (RA) and its comorbidities, in particular insulin resistance. Methods. We investigated the expression of tha main target genes implicated in vitami D metabolism on synovial samples obtained from RA and Osteoarthritis (OA) patients; moreover, we evaluated the expression of the CYP27B1, the activating enzyme of vitamin D metabolism, by synovial fibroblasts (SF) of RA patients in vitro. We also investigated, in vivo, the relevance of visceral obesity, assessed by ultrasounds, in the prediction of cardiovascular risk and glucose metabolism in the general population. Finally, we evaluated the cross-sectional association between glucose metabolism parameters and vitamin D plasma concentration in severely obese diabetic subjects. Results. In the present study we failed to demonstrate significant differences in vitamin D metabolism between RA and OA patients; however, we demonstrated that SF express CYP27B1 under inflammatory state, being potentially able to locally activate vitamin D. Moreover we confirmed that visceral obesity, a well known risk factor for hypovitaminosis D, is the main determinant of insulin resistance and is a strong predictor of cardiovascular risk. Finally, we demonstrated that vitamin D in severely obese type 2 diabetes mellitus patients predicts glycemic control. Conclusions. Our data support the hypothesis that the local conversion of vitamin D could be exploited for therapeutic use in RA; finally, the improvement of vitamin D status might have beneficial effects on different comorbidities related to RA, in particular insulin resistance.

Vitamin D in Rheumatoid Arthritis: potential implications for disease control and comorbidities management / Bellan, Mattia. - ELETTRONICO. - (2018). [10.20373/uniupo/openthesis/102686]

Vitamin D in Rheumatoid Arthritis: potential implications for disease control and comorbidities management

Bellan, Mattia
2018-01-01

Abstract

Background. Vitamin D is able to regulate the activity of immune system in vitro; whether this action has some relevance in vivo is still a matter of debate. Aim. To investigate the potential role of vitamin D in the pathogenesis and in the management of Rheumatoid Arthritis (RA) and its comorbidities, in particular insulin resistance. Methods. We investigated the expression of tha main target genes implicated in vitami D metabolism on synovial samples obtained from RA and Osteoarthritis (OA) patients; moreover, we evaluated the expression of the CYP27B1, the activating enzyme of vitamin D metabolism, by synovial fibroblasts (SF) of RA patients in vitro. We also investigated, in vivo, the relevance of visceral obesity, assessed by ultrasounds, in the prediction of cardiovascular risk and glucose metabolism in the general population. Finally, we evaluated the cross-sectional association between glucose metabolism parameters and vitamin D plasma concentration in severely obese diabetic subjects. Results. In the present study we failed to demonstrate significant differences in vitamin D metabolism between RA and OA patients; however, we demonstrated that SF express CYP27B1 under inflammatory state, being potentially able to locally activate vitamin D. Moreover we confirmed that visceral obesity, a well known risk factor for hypovitaminosis D, is the main determinant of insulin resistance and is a strong predictor of cardiovascular risk. Finally, we demonstrated that vitamin D in severely obese type 2 diabetes mellitus patients predicts glycemic control. Conclusions. Our data support the hypothesis that the local conversion of vitamin D could be exploited for therapeutic use in RA; finally, the improvement of vitamin D status might have beneficial effects on different comorbidities related to RA, in particular insulin resistance.
2018
29
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11579/102686
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