类风湿关节炎患者血清维生素D水平与疾病活动度相关

目的:探讨类风湿关节炎(Rheumatoid arthritis,RA)患者血清维生素D(25(OH)D)水平与疾病活动度的关系。方法:总共纳入180例RA患者,同时纳入60例年龄、性别相匹配的健康对照。检测所有参与者的血清25(OH)D水平及所有RA患者C反应蛋白和血沉。同时获取RA患者晨僵时间、疼痛视觉模拟表评分、乏力视觉模拟表评分、压痛关节数、肿胀关节数、健康评估量表得分、情绪变化量表得分等。利用RA患者28个关节疾病活动评分(Disease activity score in 28 joints,DAS28)评估RA疾病活动度。结果:相对于健康对照组(43.89±16.28 ng/m L),RA患者的血清25(OH)D明显降低(28.52±8.95 ng/m L)(P=0.000)。RA患者的血清25(OH)D水平越低,压痛关节数、肿胀关节数越多(P=0.043,r=-0.132;P=0.017,r=-0.177),血沉、C反应蛋白越高(P=0.018,r=-0.177;P=0.007,r=-0.200),同时DAS28评分越高(P=0.007,r=-0.201);患者的晨僵时间、疼痛评分、乏力评分、健康评估量表得分及情绪量表得分与血清维生素D水平负相关(P=0.043,r=-0.151;P=0.019,r=-0.175;P=0.006,r=-0.205;P=0.048,r=-0.147;P=0.017,r=-0.178)。结论:RA患者血清维生素D普遍缺乏,并且与RA患者疾病活动度负相关。

SerumVitamin D Levels are Associated with Disease Activity in Patientswith Rheumatoid Arthritis

Objective:To evaluate the relationship between vitamin D [25(OH)D] levels and disease activity in rheumatoid arthritis(RA) patients.Methods:180 RA patients and 80 healthy controls matched in sex and age were included in this study. The plasma 25(OH)D levels of all participants and C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) of RA patients were tested.Meantime, we got the morning stiffness, pain visual analog scale (VAS) score, asthenia VAS score, tender joint count (TJC), swollenjoint count (SJC), health assessment questionnaire (HAQ) and emotions score. The RA disease activity was evaluated by DAS28.Results:The serum 25(OH)D levels in RA patients were significantly lower than those of healthy controls (28.52± 8.95 ng/mL vs 43.89± 16.28ng/mL) (P=0.000). The concentration of vitamin D was inversely associated with the disease activity including TJC, SJC, ESR, CRP andDAS28 (P=0.043, r=-0.132; P=0.017, r=-0.177; P=0.018, r=-0.177; P=0.007, r=-0.200; P=0.007, r=-0.201). The level of 25(OH)D was alsonegatively associated with clinical parameters such as morning stiffness, pain VAS score, asthenia VAS score, HAQ score and emotionsscore (P=0.043, r=-0.151; P=0.019, r=-0.175; P=0.006, r=-0.205; P=0.048, r=-0.147; P=0.017, r=-0.178).Conclusion:The vitaminD deficiency is common in our patients with RA. The serumvitaminD level in RA patients is negatively related to the disease activity.