Impact of vitamin D deficiency on efficiency of rehabilitation programs in patients with ankylosing spondylitis
- 作者: Nikitin M.V.1, Aleksandrova N.V.2, Alekhina I.Y.3, Bezuglov I.D.4, Aleksandrov A.V.2,4, Zborovskaya I.A.2
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隶属关系:
- Sanatorium and Resort Complex “Vulan”, Research and Clinical Branch of the National Medical Research Center of Rehabilitation and Balneology
- А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
- Stavropol State Medical University
- Volgograd State Medical University
- 期: 卷 28, 编号 4 (2025)
- 页面: 1015-1022
- 栏目: SHORT COMMUNICATIONS
- URL: https://journals.rcsi.science/1028-7221/article/view/333268
- DOI: https://doi.org/10.46235/1028-7221-17285-IOV
- ID: 333268
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Low blood vitamin D concentrations are associated with incidence, risk of development, activity and more severe clinical course of ankylosing spondylitis (AS). 58 patients with AS (males 62.1%, age 48 (39-58) years) were examined to study the impact of vitamin D deficiency on the efficiency of rehabilitation measures under the programs of sanatorium and resort therapy. Determination (25-OH) of vitamin D level, haematological indices SII (systemic immune-inflammation index; SII = number of platelets × number of neutrophils/number of lymphocytes) and SIRI (systemic inflammation response index; SIRI = number of neutrophils × number of monocytes/number of lymphocytes) were performed on admission to the sanatorium and before discharge. The average BASDAI disease activity index was 3.0 (2.4-3.5) points. Low AS activity was documented in 31% and moderate activity, in 69% of patients. The baseline vitamin D levels showed negative correlation with pain intensity score (VAS, visual analog score) during walking (ρ = -0.44, p < 0.001). Association of these measures at discharge persisted but was less significant (ρ = -0.27, p = 0.039). In the total group of AS patients, vitamin D deficiency (< 20 ng/mL) was observed in 13.8%, and mild deficiency levels (ranging from 20 to 29 ng/mL) have been revealed in 25.9% of cases. When comparing patients with normal (> 30 ng/mL) and reduced (≤ 29 ng/mL) vitamin D levels, significant differences were noted for VAS (p = 0.0025), ESR (p = 0.040) and SIRI (p = 0.046). All patients with AS were divided into two groups: Group I (n = 26) admitted for treatment from regions with low level of solar insolation; Group II (n = 32) arrived for treatment from regions with high insolation levels. Initially, a significantly lower vitamin D content was observed in AS patients in group I (p = 0.040). A three-week stay and treatment at the sanatorium (an area with high solar insolation) was associated with an increase in vitamin D levels (p = 0.027), and decreased VAS pain intensity (p = 0.017) only in group II patients. When testing the inflammatory markers, only SIRI showed a significant decrease in group II patients with AS in the course of treatment (p = 0.038). In conclusion, the hematological SIRI index objectively reflects clinical dynamics of AS patients arriving for sanatorium and resort therapy from the regions with different levels of solar insolation.
作者简介
M. Nikitin
Sanatorium and Resort Complex “Vulan”, Research and Clinical Branch of the National Medical Research Center of Rehabilitation and Balneology
Email: mv-nikitin@mail.ru
ORCID iD: 0000-0001-9047-4311
SPIN 代码: 7396-3069
PhD, MD (Medicine), Chief Medical Officer
俄罗斯联邦, MoscowNinel Aleksandrova
А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
编辑信件的主要联系方式.
Email: nynel68@mail.ru
ORCID iD: 0000-0002-8124-4239
SPIN 代码: 1018-3699
Scopus 作者 ID: 57325790000
PhD (Medicine), Senior Researcher, Laboratory of Functional Research Methods, Ultrasound Diagnostics and Rehabilitation Therapy
俄罗斯联邦, VolgogradIrina Alekhina
Stavropol State Medical University
Email: postmaster@stgmu.ru
ORCID iD: 0000-0001-7968-4334
SPIN 代码: 7762-5548
PhD (Medicine), Associate Professor, Department of Hospital Therapy
俄罗斯联邦, StavropolIvan Bezuglov
Volgograd State Medical University
Email: i.bezuglov.d@bk.ru
ORCID iD: 0009-0007-1579-5765
Master’s Student, Department of Hospital Therapy
俄罗斯联邦, VolgogradAndrey Aleksandrov
А. Zborovsky Research Institute of Clinical and Experimental Rheumatology; Volgograd State Medical University
Email: imlab@mail.ru
ORCID iD: 0000-0002-0686-4067
SPIN 代码: 4755-0940
Scopus 作者 ID: 25645530000
PhD, MD (Medicine), Professor, Department of Clinical Laboratory Diagnostics, Volgograd State Medical University; Head, Laboratory of Functional Research Methods, Ultrasound Diagnostics and Rehabilitation Therapy, А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
俄罗斯联邦, Volgograd; VolgogradIrina Zborovskaya
А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
Email: zborovskayaia@mail.ru
ORCID iD: 0000-0003-3898-7667
SPIN 代码: 2165-4396
PhD, MD (Medicine), Professor, Director
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