Vitamin D and Spondyloarthritis: Review of the Literature

Chiara Crotti1, Andrea Becciolini2, Martina Biggioggero1, Ennio Giulio Favalli2, *
1 Department of Clinical Sciences and Health Community, University of Milan, Division of Rheumatology, Gaetano Pini Institute, Milan, Italy
2 Department of Rheumatology, Gaetano Pini Institute, Milan, Italy



Spondyloarthritides (SpAs) encompass heterogeneous diseases sharing similar genetic background, pathogenic mechanisms, and phenotypic features. Vitamin D is essential for calcium metabolism and skeletal homeostasis. Some recent evidences reported supplemental functions of vitamin D, such as modulation of inflammatory reactions.


To analyze published data about a possible association between vitamin D and SpAs.


Vitamin D could play a role in immune reactions, influencing both immune and adaptive response. Vitamin D deficiency is more frequent in SpAs than in general population: an active and more severe disease infers patients’ mobility and reduces sunlight exposure. Quiescent inflammatory bowel disease, frequently associated with SpAs, could worsen vitamin D deficiency. All the parameters related to UVB exposure are the most important determinants for vitamin D status and need to be considered evaluating the vitamin D levels in SpAs.

Apart from musculoskeletal problems, patients affected by SpAs frequently suffer from other comorbidities, especially cardiovascular diseases and osteoporosis, and vitamin D status could have a relevance in this field. Bone is involved in SpAs with a dualistic role, coexisting trabecular bone resorption and new bone formation.

It seems rational to monitor vitamin D levels in SpA subjects and to target it to global health threshold.


Literature data were not completely in agreement about a possible relation between poor vitamin D status and onset or worse disease course of SpAs. In fact, these results come from cross-sectional studies, which impair our ability to infer causality. Large, randomized controlled clinical trials are therefore needed.

Abstract Information

Identifiers and Pagination:

Year: 2018
Volume: 12
Publisher Item Identifier: EA-TORJ-2018-HT1-451-2

Article History:

Received Date: 12/12/2017
Revision Received Date: 25/3/2018
Acceptance Date: 22/4/2018
Electronic publication date: 25/10/2018
Collection year: 2018

© 2018 Crotti et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Correspondence: Address correspondence to this author at the Department of Rheumatology, Gaetano Pini Institute, Milan, Via Gaetano Pini, 9, 20122 Milan - Italy, Tel: +39 0258296421, Mobile: +39 3289659778, Fax: +39 0258296315; E-mail: