{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T02:13:27Z","timestamp":1768961607237,"version":"3.49.0"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Vitamin D levels tend to be lower in patients with inflammatory rheumatic diseases (IRDs), including rheumatoid arthritis (RA), but there are minimal data on vitamin D levels in rheumatology patients with inflammatory vs. non-inflammatory diagnoses. Methods: In this retrospective, observational study, we used electronic health record data from patients presenting for their first visit at a large rheumatology clinic to assess vitamin D levels and deficiency based on diagnosis, and to evaluate the association between vitamin D and inflammatory markers (including C-reactive protein [CRP]) or autoimmune markers (including rheumatoid factor [RF], anti-citrullinated peptide antibody, and anti-nuclear antibodies). Logistic regression analysis with 13 clinical variables was used to evaluate the association between vitamin D levels and IRD diagnosis, and linear regression was used to evaluate the association between vitamin D levels and CRP or RF. Results: The patient cohort included 4979 patients; 1385 (27.8%) had an IRD. Vitamin D levels were significantly lower in the IRD vs. non-inflammatory subgroup (mean [SD] of 26.6 [13.3] vs. 27.7 [14.3]; p = 0.009), but the difference was not clinically relevant given the small effect size. Vitamin D deficiency rates (&lt;20 ng\/mL) were not significantly different between the subgroups, and vitamin D was not associated with an IRD diagnosis in logistic regression analysis. In linear regression analysis, vitamin D was not associated with CRP or RF in the full patient cohort or in the subgroup with RA (n = 539). Conclusions: We conclude that vitamin D levels do not differ substantially based on IRD versus non-inflammatory diagnosis, CRP levels, or RF levels in this clinical cohort.<\/jats:p>","DOI":"10.3390\/nu18020326","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T13:02:07Z","timestamp":1768914127000},"page":"326","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vitamin D Status in Rheumatology Patients with Inflammatory Compared with Non-Inflammatory Diagnoses: Inflammatory and Autoimmune Markers Are Not Associated with Vitamin D Levels"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6600-3691","authenticated-orcid":false,"given":"Arne","family":"Sch\u00e4fer","sequence":"first","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, University Hospital W\u00fcrzburg, 97080 Wuerzburg, Germany"},{"name":"Diabetes Zentrum Mergentheim, 97980 Bad Mergentheim, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9215-6501","authenticated-orcid":false,"given":"Magdolna Szilvia","family":"Kovacs","sequence":"additional","affiliation":[{"name":"Rheumatologie, Medizinisches Versorgungszentrum (MVZ) MED BAYERN OST, 84489 Burghausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5805-806X","authenticated-orcid":false,"given":"Axel","family":"Nigg","sequence":"additional","affiliation":[{"name":"Rheumatologie, Medizinisches Versorgungszentrum (MVZ) MED BAYERN OST, 84489 Burghausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-8099","authenticated-orcid":false,"given":"Martin","family":"Feuchtenberger","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik II, University Hospital W\u00fcrzburg, 97080 Wuerzburg, Germany"},{"name":"Rheumatologie, Medizinisches Versorgungszentrum (MVZ) MED BAYERN OST, 84489 Burghausen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Charoenngam, N. (2021). Vitamin D and rheumatic diseases: A review of clinical evidence. Int. J. Mol. Sci., 22.","DOI":"10.20944\/preprints202107.0579.v1"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s40265-023-01875-8","article-title":"The role of vitamin D in health and disease: A narrative review on the mechanisms linking vitamin D with disease and the effects of supplementation","volume":"83","author":"Rebelos","year":"2023","journal-title":"Drugs"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"100129","DOI":"10.1016\/j.jtauto.2021.100129","article-title":"Autoimmune rheumatic diseases: One or many diseases?","volume":"4","author":"Moutsopoulos","year":"2021","journal-title":"J. Transl. Autoimmun."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103581","DOI":"10.1016\/j.autrev.2024.103581","article-title":"Tailoring the treatment of inflammatory rheumatic diseases by a better stratification and characterization of the clinical patient heterogeneity. Findings from a systematic literature review and experts\u2019 consensus","volume":"23","author":"Ruscitti","year":"2024","journal-title":"Autoimmun. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zou, J., Thornton, C., Chambers, E.S., Rosser, E.C., and Ciurtin, C. (2021). Exploring the evidence for an immunomodulatory role of vitamin D in juvenile and adult rheumatic disease. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.616483"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Lin, J., Liu, J., Davies, M.L., and Chen, W. (2016). Serum vitamin D level and rheumatoid arthritis disease activity: Review and meta-Analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0146351"},{"key":"ref_7","first-page":"827","article-title":"Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: A meta-analysis","volume":"34","author":"Lee","year":"2016","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.autrev.2017.03.002","article-title":"European multicentre pilot survey to assess vitamin D status in rheumatoid arthritis patients and early development of a new Patient Reported Outcome questionnaire (D-PRO)","volume":"16","author":"Vojinovic","year":"2017","journal-title":"Autoimmun. Rev."},{"key":"ref_9","first-page":"210","article-title":"Vitamin D status in spondyloarthritis: Results of the ASAS-COMOSPA international study","volume":"36","author":"Fernandes","year":"2018","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4103\/jnsbm.JNSBM_128_17","article-title":"Assessment of vitamin D in rheumatoid arthritis and its correlation with disease activity","volume":"9","author":"Meena","year":"2018","journal-title":"J. Nat. Sci. Biol. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.imlet.2019.06.005","article-title":"Does vitamin D deficiency contribute to higher disease activity in patients with spondyloarthritis?","volume":"212","author":"Kolahi","year":"2019","journal-title":"Immunol. Lett."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"152200","DOI":"10.1016\/j.semarthrit.2023.152200","article-title":"Vitamin D in psoriatic arthritis\u2014A systematic review and meta-analysis","volume":"60","author":"Kolak","year":"2023","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3899\/jrheum.100516","article-title":"Prevalence of vitamin D insufficiency\/deficiency in rheumatoid arthritis and associations with disease severity and activity","volume":"38","author":"Kerr","year":"2011","journal-title":"J. Rheumatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e31764","DOI":"10.1097\/MD.0000000000031764","article-title":"Ankylosing spondylitis disease activity and serum vitamin D levels: A systematic review and meta-analysis","volume":"101","author":"Chen","year":"2022","journal-title":"Medicine"},{"key":"ref_15","first-page":"1","article-title":"Vitamin D supplementation: Still a challenge for rheumatologists! EULAR Rheumatol","volume":"1","author":"Lems","year":"2025","journal-title":"Open"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Guan, Y., Hao, Y., Guan, Y., Bu, H., and Wang, H. (2020). The effect of vitamin D supplementation on rheumatoid arthritis patients: A systematic review and meta-analysis. Front. Med., 7.","DOI":"10.3389\/fmed.2020.596007"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Nguyen, Y., Sigaux, J., Letarouilly, J.-G., Sanchez, P., Czernichow, S., Flip, R.-M., Soubrier, M., Semerano, L., Seror, R., and Sellam, J. (2020). Efficacy of oral vitamin supplementation in inflammatory rheumatic disorders: A systematic review and meta-analysis of randomized controlled trials. Nutrients, 13.","DOI":"10.3390\/nu13010107"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"254","DOI":"10.4274\/gulhane.galenos.2020.1089","article-title":"Comparison of vitamin D profile between patients with inflammatory and non-inflammatory rheumatic diseases","volume":"62","author":"Sarpel","year":"2020","journal-title":"G\u00fclhane Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Feuchtenberger, M., Kovacs, M.S., Nigg, A., and Sch\u00e4fer, A. (2025). Vitamin D levels in patients presenting to a rheumatology clinic in Germany: Associations with patient characteristics and season. Nutrients, 17.","DOI":"10.3390\/nu17111893"},{"key":"ref_20","unstructured":"(2025, October 25). Elecsys Vitamin D Total III. Available online: https:\/\/elabdoc-prod.roche.com\/eLD\/api\/downloads\/17cc76c6-db3a-f011-2f91-005056a71a5d?countryIsoCode=XG."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Dai, Z., McKenzie, J.E., McDonald, S., Baram, L., Page, M.J., Allman-Farinelli, M., Raubenheimer, D., and Bero, L.A. (2021). Assessment of the methods used to develop vitamin D and calcium recommendations\u2014A systematic review of bone health guidelines. Nutrients, 13.","DOI":"10.1101\/2021.05.01.21256288"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1146\/annurev.publhealth.23.100901.140546","article-title":"The importance of the normality assumption in large public health data sets","volume":"23","author":"Lumley","year":"2002","journal-title":"Annu. Rev. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s00296-010-1736-3","article-title":"The status of serum vitamin D in patients with rheumatoid arthritis and undifferentiated inflammatory arthritis compared with controls","volume":"32","author":"Heidari","year":"2012","journal-title":"Rheumatol. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1007\/s00296-014-3019-x","article-title":"Low vitamin D level is not associated with increased incidence of rheumatoid arthritis","volume":"34","author":"Cote","year":"2014","journal-title":"Rheumatol. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e676","DOI":"10.1002\/iid3.676","article-title":"Profiling vitamin D, its mediators and proinflammatory cytokines in rheumatoid arthritis: A case\u2013control study","volume":"10","author":"Sakyi","year":"2022","journal-title":"Immun. Inflamm. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s00198-010-1362-7","article-title":"25-Hydroxyvitamin D in Canadian adults: Biological, environmental, and behavioral correlates","volume":"22","author":"Berger","year":"2011","journal-title":"Osteoporos. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"17685","DOI":"10.1038\/s41598-019-53864-1","article-title":"Disassociation of vitamin D\u2019s calcemic activity and non-calcemic genomic activity and individual responsiveness: A randomized controlled double-blind clinical trial","volume":"9","author":"Shirvani","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Subramanian, A., Burrowes, H.B., Rumph, J.T., Wilkerson, J., Jackson, C.L., and Jukiz, A.M.Z. (2024). Vitamin D levels in the United States: Temporal trends (2011\u20132018) and contemporary associations with sociodemographic characteristics (2017\u20132018). Nutrients, 16.","DOI":"10.3390\/nu16193414"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.1002\/acr.21715","article-title":"Association of vitamin D with cardiometabolic risk factors in rheumatoid arthritis","volume":"64","author":"Haque","year":"2012","journal-title":"Arthritis Care Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e066452","DOI":"10.1136\/bmj-2021-066452","article-title":"Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial","volume":"376","author":"Hahn","year":"2022","journal-title":"BMJ"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Dong, Y., Zhu, H., Chen, L., Huang, Y., Christen, W., Cook, N.R., Copeland, T., Mora, S., Buring, J.E., and Lee, I.-M. (2022). Effects of vitamin D3 and marine omega-3 fatty acids supplementation on biomarkers of systemic inflammation: 4-year findings from the VITAL randomized trial. Nutrients, 14.","DOI":"10.3390\/nu14245307"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1559","DOI":"10.1158\/1055-9965.EPI-16-0339","article-title":"Association between vitamin D deficiency and antinuclear antibodies in middle-aged and older U.S. adults","volume":"25","author":"Meier","year":"2016","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1093\/geronb\/gbq008","article-title":"Predictors of C-reactive protein in the National Social Life, Health, and Aging Project","volume":"66","author":"McDade","year":"2011","journal-title":"J. Gerontol. B Psychol. Sci. Soc. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Togashi, T., Ishihara, R., Watanabe, R., Shiomi, M., Yano, Y., Fujisawa, Y., Katsushima, M., Fukumoto, K., Yamada, S., and Hashimoto, M. (2025). Rheumatoid factor: Diagnostic and prognostic performance and therapeutic implications in rheumatoid arthritis. J. Clin. Med., 14.","DOI":"10.3390\/jcm14051529"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1017\/S0007114518000491","article-title":"Vitamin D deficiency and insufficiency among US adults: Prevalence, predictors and clinical implications","volume":"119","author":"Liu","year":"2018","journal-title":"Br. J. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/2\/326\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T13:12:21Z","timestamp":1768914741000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/18\/2\/326"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,20]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["nu18020326"],"URL":"https:\/\/doi.org\/10.3390\/nu18020326","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,20]]}}}