Association between metabolic syndrome, BMI, and serum vitamin D concentrations in rheumatoid arthritis
Identifieur interne : 000A67 ( Istex/Corpus ); précédent : 000A66; suivant : 000A68Association between metabolic syndrome, BMI, and serum vitamin D concentrations in rheumatoid arthritis
Auteurs : Ladan Goshayeshi ; Hamidreza Saber ; Maryam Sahebari ; Zahra Rezaieyazdi ; Houshang Rafatpanah ; Habibollah Esmaily ; Lena GoshayeshiSource :
- Clinical Rheumatology [ 0770-3198 ] ; 2012-08-01.
English descriptors
Abstract
Abstract: Rheumatoid arthritis (RA) is the most common autoimmune arthritis. The impact of chronic inflammation on atherosclerosis and insulin resistance has been observed in several autoimmune diseases. On the other hand, metabolic syndrome (MetS); a cluster of traditional risk factors for atherosclerosis and diabetes seems to be prevalent in RA patients. It is reasonable to think that protective factors against inflammation can protect patients against atherosclerosis and diabetes, too. Vitamin D (Vit D), a novel immunomodulator, is recently considered to play a protective role against cardiovascular diseases, insulin resistance, and obesity. This cross-sectional study was designed to evaluate the impact of serum Vit D on MetS and body mass index (BMI). One hundred twenty RA patients were enrolled. MetS was assessed according to Adult Treatment Panel III criteria. All patients with known confounders influencing Vit D serum levels were excluded. Serum value of 25-hydroxyvitamin D (25(OH)D) was measured using a commercial ELISA kit. Data were analyzed by SPSS software. A logistic regression analysis stated that prednisolone dosage [p = 0.028, β = 0.177, odds ratio (OR) = 1.194, confidence interval (CI, 1.09–1.32)], age [p = 0.002, β = 0.146, OR = 1.57, CI (1.05–1.27)] and Vit D serum levels [p = 0.049, β = −3.766, OR = 0.023, CI (0.001–0.978)] are all significant predictors of MetS occurrence in RA patients. It was shown that 25(OH)D is a protective factor against MetS. It was also shown that there is a negative correlation between BMI and 25(OH)D serum levels (P = 0.037, r s = −0.266). In summary, this study suggested that 25(OH)D plays a protective role against MetS in RA patients. However, this cross-sectional study did not permit a power calculation on the causal relationship between Vit D and metabolic syndrome. On the other hand, Vit D has a negative correlation with BMI in these patients.
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DOI: 10.1007/s10067-012-1995-3
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The impact of chronic inflammation on atherosclerosis and insulin resistance has been observed in several autoimmune diseases. On the other hand, metabolic syndrome (MetS); a cluster of traditional risk factors for atherosclerosis and diabetes seems to be prevalent in RA patients. It is reasonable to think that protective factors against inflammation can protect patients against atherosclerosis and diabetes, too. Vitamin D (Vit D), a novel immunomodulator, is recently considered to play a protective role against cardiovascular diseases, insulin resistance, and obesity. This cross-sectional study was designed to evaluate the impact of serum Vit D on MetS and body mass index (BMI). One hundred twenty RA patients were enrolled. MetS was assessed according to Adult Treatment Panel III criteria. All patients with known confounders influencing Vit D serum levels were excluded. Serum value of 25-hydroxyvitamin D (25(OH)D) was measured using a commercial ELISA kit. Data were analyzed by SPSS software. A logistic regression analysis stated that prednisolone dosage [p = 0.028, β = 0.177, odds ratio (OR) = 1.194, confidence interval (CI, 1.09–1.32)], age [p = 0.002, β = 0.146, OR = 1.57, CI (1.05–1.27)] and Vit D serum levels [p = 0.049, β = −3.766, OR = 0.023, CI (0.001–0.978)] are all significant predictors of MetS occurrence in RA patients. It was shown that 25(OH)D is a protective factor against MetS. It was also shown that there is a negative correlation between BMI and 25(OH)D serum levels (P = 0.037, r s = −0.266). In summary, this study suggested that 25(OH)D plays a protective role against MetS in RA patients. However, this cross-sectional study did not permit a power calculation on the causal relationship between Vit D and metabolic syndrome. On the other hand, Vit D has a negative correlation with BMI in these patients.</div></front></TEI><istex><corpusName>springer-journals</corpusName><author><json:item><name>Ladan Goshayeshi</name><affiliations><json:string>School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string></affiliations></json:item><json:item><name>HamidReza Saber</name><affiliations><json:string>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string></affiliations></json:item><json:item><name>Maryam Sahebari</name><affiliations><json:string>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string><json:string>Rheumatic Diseases Research Center (RDRC), Ghaem hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string><json:string>E-mail: sahebarim@mums.ac.ir</json:string></affiliations></json:item><json:item><name>Zahra Rezaieyazdi</name><affiliations><json:string>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string></affiliations></json:item><json:item><name>Houshang Rafatpanah</name><affiliations><json:string>Immunology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string></affiliations></json:item><json:item><name>Habibollah Esmaily</name><affiliations><json:string>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string></affiliations></json:item><json:item><name>Lena Goshayeshi</name><affiliations><json:string>Microbiology and Virology Research Center, Avesina Research Institute, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>BMI</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Body mass index</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Metabolic syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Rheumatoid arthritis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Vitamin D</value></json:item></subject><articleId><json:string>1995</json:string><json:string>s10067-012-1995-3</json:string></articleId><arkIstex>ark:/67375/VQC-15FZ0B1H-H</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>OriginalPaper</json:string></originalGenre><abstract>Abstract: Rheumatoid arthritis (RA) is the most common autoimmune arthritis. The impact of chronic inflammation on atherosclerosis and insulin resistance has been observed in several autoimmune diseases. On the other hand, metabolic syndrome (MetS); a cluster of traditional risk factors for atherosclerosis and diabetes seems to be prevalent in RA patients. It is reasonable to think that protective factors against inflammation can protect patients against atherosclerosis and diabetes, too. Vitamin D (Vit D), a novel immunomodulator, is recently considered to play a protective role against cardiovascular diseases, insulin resistance, and obesity. This cross-sectional study was designed to evaluate the impact of serum Vit D on MetS and body mass index (BMI). One hundred twenty RA patients were enrolled. MetS was assessed according to Adult Treatment Panel III criteria. All patients with known confounders influencing Vit D serum levels were excluded. Serum value of 25-hydroxyvitamin D (25(OH)D) was measured using a commercial ELISA kit. Data were analyzed by SPSS software. A logistic regression analysis stated that prednisolone dosage [p = 0.028, β = 0.177, odds ratio (OR) = 1.194, confidence interval (CI, 1.09–1.32)], age [p = 0.002, β = 0.146, OR = 1.57, CI (1.05–1.27)] and Vit D serum levels [p = 0.049, β = −3.766, OR = 0.023, CI (0.001–0.978)] are all significant predictors of MetS occurrence in RA patients. It was shown that 25(OH)D is a protective factor against MetS. It was also shown that there is a negative correlation between BMI and 25(OH)D serum levels (P = 0.037, r s = −0.266). In summary, this study suggested that 25(OH)D plays a protective role against MetS in RA patients. However, this cross-sectional study did not permit a power calculation on the causal relationship between Vit D and metabolic syndrome. 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The impact of chronic inflammation on atherosclerosis and insulin resistance has been observed in several autoimmune diseases. On the other hand, metabolic syndrome (MetS); a cluster of traditional risk factors for atherosclerosis and diabetes seems to be prevalent in RA patients. It is reasonable to think that protective factors against inflammation can protect patients against atherosclerosis and diabetes, too. Vitamin D (Vit D), a novel immunomodulator, is recently considered to play a protective role against cardiovascular diseases, insulin resistance, and obesity. This cross-sectional study was designed to evaluate the impact of serum Vit D on MetS and body mass index (BMI). One hundred twenty RA patients were enrolled. MetS was assessed according to Adult Treatment Panel III criteria. All patients with known confounders influencing Vit D serum levels were excluded. Serum value of 25-hydroxyvitamin D (25(OH)D) was measured using a commercial ELISA kit. Data were analyzed by SPSS software. A logistic regression analysis stated that prednisolone dosage [p = 0.028, β = 0.177, odds ratio (OR) = 1.194, confidence interval (CI, 1.09–1.32)], age [p = 0.002, β = 0.146, OR = 1.57, CI (1.05–1.27)] and Vit D serum levels [p = 0.049, β = −3.766, OR = 0.023, CI (0.001–0.978)] are all significant predictors of MetS occurrence in RA patients. It was shown that 25(OH)D is a protective factor against MetS. It was also shown that there is a negative correlation between BMI and 25(OH)D serum levels (P = 0.037, r s = −0.266). In summary, this study suggested that 25(OH)D plays a protective role against MetS in RA patients. However, this cross-sectional study did not permit a power calculation on the causal relationship between Vit D and metabolic syndrome. 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NumberingStyle="Unnumbered"><JournalID>10067</JournalID><JournalPrintISSN>0770-3198</JournalPrintISSN><JournalElectronicISSN>1434-9949</JournalElectronicISSN><JournalTitle>Clinical Rheumatology</JournalTitle><JournalSubTitle>Journal of the International League of Associations for Rheumatology</JournalSubTitle><JournalAbbreviatedTitle>Clin Rheumatol</JournalAbbreviatedTitle><JournalSubjectGroup><JournalSubject Type="Primary">Medicine & Public Health</JournalSubject><JournalSubject Type="Secondary">Rheumatology</JournalSubject><SubjectCollection Code="Medicine">SC11</SubjectCollection></JournalSubjectGroup></JournalInfo><Volume OutputMedium="All"><VolumeInfo TocLevels="0" VolumeType="Regular"><VolumeIDStart>31</VolumeIDStart><VolumeIDEnd>31</VolumeIDEnd><VolumeIssueCount>12</VolumeIssueCount></VolumeInfo><Issue IssueType="Regular" OutputMedium="All"><IssueInfo IssueType="Regular" TocLevels="0"><IssueIDStart>8</IssueIDStart><IssueIDEnd>8</IssueIDEnd><IssueArticleCount>20</IssueArticleCount><IssueHistory><OnlineDate><Year>2012</Year><Month>7</Month><Day>31</Day></OnlineDate><PrintDate><Year>2012</Year><Month>7</Month><Day>30</Day></PrintDate><CoverDate><Year>2012</Year><Month>8</Month></CoverDate><PricelistYear>2012</PricelistYear></IssueHistory><IssueCopyright><CopyrightHolderName>Clinical Rheumatology</CopyrightHolderName><CopyrightYear>2012</CopyrightYear></IssueCopyright></IssueInfo><Article ID="s10067-012-1995-3" OutputMedium="All"><ArticleInfo ArticleType="OriginalPaper" ContainsESM="No" Language="En" NumberingStyle="Unnumbered" TocLevels="0"><ArticleID>1995</ArticleID><ArticleDOI>10.1007/s10067-012-1995-3</ArticleDOI><ArticleSequenceNumber>8</ArticleSequenceNumber><ArticleTitle Language="En">Association between metabolic syndrome, BMI, and serum vitamin D concentrations in rheumatoid arthritis</ArticleTitle><ArticleCategory>Original Article</ArticleCategory><ArticleFirstPage>1197</ArticleFirstPage><ArticleLastPage>1203</ArticleLastPage><ArticleHistory><RegistrationDate><Year>2012</Year><Month>4</Month><Day>27</Day></RegistrationDate><Received><Year>2011</Year><Month>10</Month><Day>7</Day></Received><Revised><Year>2012</Year><Month>4</Month><Day>5</Day></Revised><Accepted><Year>2012</Year><Month>4</Month><Day>26</Day></Accepted><OnlineDate><Year>2012</Year><Month>5</Month><Day>13</Day></OnlineDate></ArticleHistory><ArticleCopyright><CopyrightHolderName>Clinical Rheumatology</CopyrightHolderName><CopyrightYear>2012</CopyrightYear></ArticleCopyright><ArticleGrants Type="Regular"><MetadataGrant Grant="OpenAccess"></MetadataGrant><AbstractGrant Grant="OpenAccess"></AbstractGrant><BodyPDFGrant Grant="Restricted"></BodyPDFGrant><BodyHTMLGrant Grant="Restricted"></BodyHTMLGrant><BibliographyGrant Grant="Restricted"></BibliographyGrant><ESMGrant Grant="Restricted"></ESMGrant></ArticleGrants></ArticleInfo><ArticleHeader><AuthorGroup><Author AffiliationIDS="Aff1"><AuthorName DisplayOrder="Western"><GivenName>Ladan</GivenName><FamilyName>Goshayeshi</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>HamidReza</GivenName><FamilyName>Saber</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2 Aff5" CorrespondingAffiliationID="Aff5"><AuthorName DisplayOrder="Western"><GivenName>Maryam</GivenName><FamilyName>Sahebari</FamilyName></AuthorName><Contact><Phone>+98-511-8012753</Phone><Fax>+98-511-8401036</Fax><Email>sahebarim@mums.ac.ir</Email></Contact></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Zahra</GivenName><FamilyName>Rezaieyazdi</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff3"><AuthorName DisplayOrder="Western"><GivenName>Houshang</GivenName><FamilyName>Rafatpanah</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff2"><AuthorName DisplayOrder="Western"><GivenName>Habibollah</GivenName><FamilyName>Esmaily</FamilyName></AuthorName></Author><Author AffiliationIDS="Aff4"><AuthorName DisplayOrder="Western"><GivenName>Lena</GivenName><FamilyName>Goshayeshi</FamilyName></AuthorName></Author><Affiliation ID="Aff1"><OrgDivision>School of Medicine</OrgDivision><OrgName>Mashhad University of Medical Sciences</OrgName><OrgAddress><City>Mashhad</City><Country Code="IR">Iran</Country></OrgAddress></Affiliation><Affiliation ID="Aff2"><OrgDivision>Rheumatic Diseases Research Center (RDRC), School of Medicine</OrgDivision><OrgName>Mashhad University of Medical Sciences</OrgName><OrgAddress><City>Mashhad</City><Country Code="IR">Iran</Country></OrgAddress></Affiliation><Affiliation ID="Aff3"><OrgDivision>Immunology Research Center, School of Medicine</OrgDivision><OrgName>Mashhad University of Medical Sciences</OrgName><OrgAddress><City>Mashhad</City><Country Code="IR">Iran</Country></OrgAddress></Affiliation><Affiliation ID="Aff4"><OrgDivision>Microbiology and Virology Research Center, Avesina Research Institute, School of Medicine</OrgDivision><OrgName>Mashhad University of Medical Sciences</OrgName><OrgAddress><City>Mashhad</City><Country Code="IR">Iran</Country></OrgAddress></Affiliation><Affiliation ID="Aff5"><OrgDivision>Rheumatic Diseases Research Center (RDRC), Ghaem hospital, Faculty of Medicine</OrgDivision><OrgName>Mashhad University of Medical Sciences</OrgName><OrgAddress><City>Mashhad</City><Country Code="IR">Iran</Country></OrgAddress></Affiliation></AuthorGroup><Abstract ID="Abs1" Language="En" OutputMedium="All"><Heading>Abstract</Heading><Para>Rheumatoid arthritis (RA) is the most common autoimmune arthritis. The impact of chronic inflammation on atherosclerosis and insulin resistance has been observed in several autoimmune diseases. On the other hand, metabolic syndrome (MetS); a cluster of traditional risk factors for atherosclerosis and diabetes seems to be prevalent in RA patients. It is reasonable to think that protective factors against inflammation can protect patients against atherosclerosis and diabetes, too. Vitamin D (Vit D), a novel immunomodulator, is recently considered to play a protective role against cardiovascular diseases, insulin resistance, and obesity. This cross-sectional study was designed to evaluate the impact of serum Vit D on MetS and body mass index (BMI). One hundred twenty RA patients were enrolled. MetS was assessed according to Adult Treatment Panel III criteria. All patients with known confounders influencing Vit D serum levels were excluded. Serum value of 25-hydroxyvitamin D (25(OH)D) was measured using a commercial ELISA kit. Data were analyzed by SPSS software. A logistic regression analysis stated that prednisolone dosage [<Emphasis Type="Italic">p</Emphasis> = 0.028, <Emphasis Type="Italic">β</Emphasis> = 0.177, odds ratio (OR) = 1.194, confidence interval (CI, 1.09–1.32)], age [<Emphasis Type="Italic">p</Emphasis> = 0.002, <Emphasis Type="Italic">β</Emphasis> = 0.146, OR = 1.57, CI (1.05–1.27)] and Vit D serum levels [<Emphasis Type="Italic">p</Emphasis> = 0.049, <Emphasis Type="Italic">β</Emphasis> = −3.766, OR = 0.023, CI (0.001–0.978)] are all significant predictors of MetS occurrence in RA patients. It was shown that 25(OH)D is a protective factor against MetS. It was also shown that there is a negative correlation between BMI and 25(OH)D serum levels (<Emphasis Type="Italic">P</Emphasis> = 0.037, <Emphasis Type="Italic">r</Emphasis><Subscript>s</Subscript> = −0.266). In summary, this study suggested that 25(OH)D plays a protective role against MetS in RA patients. However, this cross-sectional study did not permit a power calculation on the causal relationship between Vit D and metabolic syndrome. On the other hand, Vit D has a negative correlation with BMI in these patients.</Para></Abstract><KeywordGroup Language="En" OutputMedium="All"><Heading>Keywords</Heading><Keyword>BMI</Keyword><Keyword>Body mass index</Keyword><Keyword>Metabolic syndrome</Keyword><Keyword>Rheumatoid arthritis</Keyword><Keyword>Vitamin D</Keyword></KeywordGroup></ArticleHeader><NoBody></NoBody></Article></Issue></Volume></Journal></Publisher></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Association between metabolic syndrome, BMI, and serum vitamin D concentrations in rheumatoid arthritis</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Association between metabolic syndrome, BMI, and serum vitamin D concentrations in rheumatoid arthritis</title></titleInfo><name type="personal"><namePart type="given">Ladan</namePart><namePart type="family">Goshayeshi</namePart><affiliation>School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">HamidReza</namePart><namePart type="family">Saber</namePart><affiliation>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Maryam</namePart><namePart type="family">Sahebari</namePart><affiliation>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><affiliation>Rheumatic Diseases Research Center (RDRC), Ghaem hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><affiliation>E-mail: sahebarim@mums.ac.ir</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zahra</namePart><namePart type="family">Rezaieyazdi</namePart><affiliation>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Houshang</namePart><namePart type="family">Rafatpanah</namePart><affiliation>Immunology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Habibollah</namePart><namePart type="family">Esmaily</namePart><affiliation>Rheumatic Diseases Research Center (RDRC), School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lena</namePart><namePart type="family">Goshayeshi</namePart><affiliation>Microbiology and Virology Research Center, Avesina Research Institute, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="OriginalPaper" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>Springer-Verlag</publisher><place><placeTerm type="text">London</placeTerm></place><dateCreated encoding="w3cdtf">2011-10-07</dateCreated><dateIssued encoding="w3cdtf">2012-08-01</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><abstract lang="en">Abstract: Rheumatoid arthritis (RA) is the most common autoimmune arthritis. The impact of chronic inflammation on atherosclerosis and insulin resistance has been observed in several autoimmune diseases. On the other hand, metabolic syndrome (MetS); a cluster of traditional risk factors for atherosclerosis and diabetes seems to be prevalent in RA patients. It is reasonable to think that protective factors against inflammation can protect patients against atherosclerosis and diabetes, too. Vitamin D (Vit D), a novel immunomodulator, is recently considered to play a protective role against cardiovascular diseases, insulin resistance, and obesity. This cross-sectional study was designed to evaluate the impact of serum Vit D on MetS and body mass index (BMI). One hundred twenty RA patients were enrolled. MetS was assessed according to Adult Treatment Panel III criteria. All patients with known confounders influencing Vit D serum levels were excluded. Serum value of 25-hydroxyvitamin D (25(OH)D) was measured using a commercial ELISA kit. Data were analyzed by SPSS software. A logistic regression analysis stated that prednisolone dosage [p = 0.028, β = 0.177, odds ratio (OR) = 1.194, confidence interval (CI, 1.09–1.32)], age [p = 0.002, β = 0.146, OR = 1.57, CI (1.05–1.27)] and Vit D serum levels [p = 0.049, β = −3.766, OR = 0.023, CI (0.001–0.978)] are all significant predictors of MetS occurrence in RA patients. It was shown that 25(OH)D is a protective factor against MetS. It was also shown that there is a negative correlation between BMI and 25(OH)D serum levels (P = 0.037, r s = −0.266). In summary, this study suggested that 25(OH)D plays a protective role against MetS in RA patients. However, this cross-sectional study did not permit a power calculation on the causal relationship between Vit D and metabolic syndrome. On the other hand, Vit D has a negative correlation with BMI in these patients.</abstract><note>Original Article</note><subject lang="en"><genre>Keywords</genre><topic>BMI</topic><topic>Body mass index</topic><topic>Metabolic syndrome</topic><topic>Rheumatoid arthritis</topic><topic>Vitamin D</topic></subject><relatedItem type="host"><titleInfo><title>Clinical Rheumatology</title><subTitle>Journal of the International League of Associations for Rheumatology</subTitle></titleInfo><titleInfo type="abbreviated"><title>Clin Rheumatol</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><originInfo><publisher>Springer</publisher><dateIssued encoding="w3cdtf">2012-07-31</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><subject><genre>Journal-Subject-Collection</genre><topic authority="SpringerSubjectCodes" authorityURI="Medicine">SC11</topic></subject><subject><genre>Medicine & Public Health</genre><topic>Rheumatology</topic></subject><identifier type="ISSN">0770-3198</identifier><identifier type="eISSN">1434-9949</identifier><identifier type="JournalID">10067</identifier><identifier type="IssueArticleCount">20</identifier><identifier type="VolumeIssueCount">12</identifier><part><date>2012</date><detail type="volume"><number>31</number><caption>vol.</caption></detail><detail type="issue"><number>8</number><caption>no.</caption></detail><extent unit="pages"><start>1197</start><end>1203</end></extent></part><recordInfo><recordOrigin>Clinical Rheumatology, 2012</recordOrigin></recordInfo></relatedItem><identifier type="istex">5FCF668AB9D9A0FF9452E1CACA1A2ACCAA1B384B</identifier><identifier type="ark">ark:/67375/VQC-15FZ0B1H-H</identifier><identifier type="DOI">10.1007/s10067-012-1995-3</identifier><identifier type="ArticleID">1995</identifier><identifier type="ArticleID">s10067-012-1995-3</identifier><accessCondition type="use and reproduction" contentType="copyright">Clinical Rheumatology, 2012</accessCondition><recordInfo><recordContentSource authority="ISTEX" authorityURI="https://loaded-corpus.data.istex.fr" valueURI="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-3XSW68JL-F">springer</recordContentSource><recordOrigin>Clinical Rheumatology, 2012</recordOrigin></recordInfo></mods><json:item><extension>json</extension><original>false</original><mimetype>application/json</mimetype><uri>https://api.istex.fr/ark:/67375/VQC-15FZ0B1H-H/record.json</uri></json:item></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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