Rheumatoid Arthritis and its Relationship with Vitamin D, ESR, and Obesity

Year : 2024 | Volume :01 | Issue : 01 | Page : 06-12

Fatima Rashid Mohan

Aya Talib Jawad

Amany Shakeir Jaber


Recent years have seen a rise in the prevalence of rheumatoid arthritis (RA), a disease marked by the destruction of articular cartilage and ankylosis of the joints, as well as other complications such as diffuse lung inflammation, sclera, pleura, pericardium, and nodular lesions, which are also common in subcutaneous tissue. Reviewing RA symptoms, diagnosis, treatment, and associations with vitamin D, ESR, and obesity was the aim of the study. Even though erythrocyte sedimentation rate (ESR) is not an etiologic diagnosis, it can be regularly utilized for inflammatory surveillance in individuals with RA. It is brought about by the straightforward, useful, affordable, point-of-care examination method known as ESR, which also has substantial clinical significance. The majority of earlier research has shown that vitamin D insufficiency is the cause of rheumatoid arthritis. Flares and remissions are features of rheumatoid arthritis (RA), an inflammatory illness that is marked by pain. Diffuse musculoskeletal discomfort is also known to be linked to vitamin D insufficiency. Excess visceral adiposity is linked to higher levels of systemic cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Obesity is an inflammatory state. This finding has given rise to the theory that obesity plays a role in the onset, progression, and maintenance of systemic inflammatory diseases, such as inflammatory arthritis. This theory is supported by the finding that psoriasis, psoriatic arthritis, and metabolic obesity appear to be strongly correlated, and that those who lose weight following bariatric surgery have a significantly lower chance of developing psoriasis. We found that patients with RA who were obese had a higher likelihood of having elevated inflammatory markers after examining
other studies.

Keywords: Obesity, Vit D, ESR, and RA, C-reactive protein

[This article belongs to International Journal of Toxins and Toxics(ijtt)]

How to cite this article: Fatima Rashid Mohan, Aya Talib Jawad, Amany Shakeir Jaber. Rheumatoid Arthritis and its Relationship with Vitamin D, ESR, and Obesity. International Journal of Toxins and Toxics. 2024; 01(01):06-12.
How to cite this URL: Fatima Rashid Mohan, Aya Talib Jawad, Amany Shakeir Jaber. Rheumatoid Arthritis and its Relationship with Vitamin D, ESR, and Obesity. International Journal of Toxins and Toxics. 2024; 01(01):06-12. Available from: https://journals.stmjournals.com/ijtt/article=2024/view=133815


  1. Smolen JS, Aletaha D, Barton A, et al. Rheumatoid arthritis. Nat Rev Dis Primers. 2018 8;4:18001.
  2. Eriksson JK, Neovius M, Bratt J et al. Biological vs. conventional combination treatment and work loss in early rheumatoid arthritis: A randomized trial. JAMA. Intern. Med. 173(15), 1407–1414 (2013).
  3. Cutolo M, Kitas GD, van Riel PL. Burden of disease in treated rheumatoid arthritis patients: Going beyond the joint. Semin. Arthritis. Rheum. 43(4), 479–488 (2014).
  4. Naranjo A, Sokka T, Descalzo MA et al. Cardiovascular disease in patients with rheumatoid arthritis: Results from the QUEST-RA study. Arthritis. Res. Ther. 10(2), R30 (2008).
  5. Armstrong DJ, McCausland EM, Quinn AD et al. Obesity and cardiovascular risk factors in rheumatoid arthritis. Rheumatol (Oxford). 45(6), 782–783 (2006).
  6. Stavropoulos-Kalinoglou A, Metsios GS, KoutedakisY et al. Obesity in rheumatoid arthritis. Rheumatol (Oxford). 50(3), 450–462 (2011).
  7. Ellerby N, Mattey DL, Packham J et al. Obesity and comorbidity are independently associated with a failure to achieve remission in patients with established rheumatoid arthritis. Ann. Rheum. Dis. 73, e74 (2014).
  8. Stavropoulos-Kalinoglou A, Metsios GS, Panoulas VF et al. Underweight and obese states both associate with worse disease activity and physical function in patients with established rheumatoid arthritis. Clin. Rheumatol. 28(4), 439–445 (2009).
  9. Baker JF, Ostergaard M, George M et al. Greater body mass independently predicts less radiographic progression on X-ray and MRI over 1-2 years. Ann. Rheum. Dis. 73(11), 1923– 1938 (2014).
  10. Westhoff G, Rau R, Zink A. Radiographic joint damage in early rheumatoid arthritis is highly dependent on body mass index. Arthritis. Rheum. 56(11), 3575–3827 (2007).
  11. Aletaha D, Neogi T, Silman AJ et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis. 69(9), 1580–1588 (2010).
  12. van Riel PL. The development of the Disease Activity Score (DAS) and the disease activity score using 28 joint counts (DAS28). Clin. Exp. Rheumatol. 32(5 Suppl 85), S65–S74 (2014).
  13. Bruce B, Fries J. The stanford health assessment questionnaire: A review of its history, issues, progress, and documentation. Rheumatol. 30(1), 167–178 (2003).
  14. van der Helm-van Mil AH, van der Kooij SM, Allaart CF et al. A high body mass index has a protective effect on the amount of joint destruction in small joints in early rheumatoid arthritis. Ann. Rheum. Dis. 67(6), 769–774 (2008).
  15. Younis KR, Al-Bustany DA. Prevalence of obesity in rheumatoid arthritis and its association with disease activity and latex positivity in a sample of patients in Erbil. Zanko. J. Med. Sci. 21(2), 1726–1735 (2017).
  16. Crowson CS, Matteson EL, Davis JM et al. Contribution of obesity to the rise in incidence of rheumatoid arthritis. Arthritis. Care. Res. 65(1), 71–77 (2013).
  17. Giles J, Ling S, Ferruci L et al. Abnormal body composition phenotypes in older rheumatoid arthritis patients: Association with disease characteristics and pharmacotherapies. Arthritis. Care. Res. 59(6), 807–815 (2008).
  18. Levitsky A, Brismar K, Hafström I et al. Obesity is a strong predictor of worse clinical outcomes and treatment responses in early rheumatoid arthritis: results from the SWEFOT trial. RMD. Open. 3(2), e000458 (2017).
  19. Jawaheer D, Olsen J, Lahiff M et al. Gender, body mass index and rheumatoid arthritis disease activity: Results from the QUEST-RA Study. Clin. Exp. Rheumatol. 28(4), 454–461 (2010).
  20. Atwa, M. A., Balata, M. G., Hussein, A. M., Abdelrahman, N. I., &Elminshawy, H. H. (2013). Serum 25-hydroxyvitamin D concentration in patients with psoriasis and rheumatoid arthritis and its association with disease activity and serum tumor necrosis factor-alpha. Saudi Med J, 34(8), 806-13.
  21. Haque, U. J., & Bartlett, S. J. (2010). Relationships among vitamin D, disease activity, pain and disability in rheumatoid arthritis. ClinExpRheumatol, 28(5), 745-7
  22. Merlino, L. A., Curtis, J., Mikuls, T. R., Cerhan, J. R., Criswell, L. A., &Saag, K. G. (2004). Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 50(1), 72-77.
  23. Sukharani, N., Dev, K., Rahul, F. N. U., Bai, P., Ali, A., Avinash, F. N. U., … &Rizwan, A. (2021). Association between rheumatoid arthritis and serum vitamin D levels. Cureus, 13(9).
  24. Meena, N., Chawla, S. P. S., Garg, R., Batta, A., &Kaur, S. (2018). Assessment of vitamin D in rheumatoid arthritis and its correlation with disease activity. Journal of natural science, biology, and medicine, 9(1), 54.
  25. Azzeh, F. S., &Kensara, O. A. (2015). Vitamin D is a good marker for disease activity of rheumatoid arthritis disease. Disease markers, 2015.
  26. Ajeganova S, Andersson ML, Hafström I et al. Association of obesity with worse disease severity in rheumatoid arthritis as well as with comorbidities: A long-term follow up from disease onset. Arthritis. Care. Res. 65(1), 78–87 (2013).
  27. Pedersen M, Jacobsen S, Klarlund M et al. Environmental risk factors differ between rheumatoid arthritis with and without auto-antibodies against cyclic citrullinated peptides. Arthritis. Res. Ther. 8(4), R133 (2006).
  28. Assasi N, Blackhouse G, Campbell K, Hopkins RB, Levine M, Richter T, et al. (2015). Comparative value of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) testing in combination versus individually for the diagnosis of undifferentiated patients with suspected inflammatory disease or serious infection: a systematic review. 28(1):79–80.
  29. Mercan, R., Bitik, B., Tufan, A., Bozbulut, U. B., Atas, N., Ozturk, M. A., Haznedaroglu, S., and Goker, B. (2016). The Association Between Neutrophil/Lymphocyte Ratio and Disease Activity in Rheumatoid Arthritis and Ankylosing Spondylitis. J Clin Lab Anal.; 30(5): 597–601.
  30. Shrivastava, A. K., Singh, H. V., Raizada, A., Singh, S. K., Pandey, A., Singh, N., Yadav, D. S., and Sharma, H. (2015). Inflammatory markers in patients with rheumatoid arthritis. Allergologia et Immunopathologia, 43(1), 81–87.

Regular Issue Subscription Review Article
Volume 01
Issue 01
Received February 8, 2024
Accepted February 16, 2024
Published February 27, 2024