Changes and clinical significance of serum 25-hydroxylvitamin D levels in Rheumatoid arthritis

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  Objectives:To determine the serum levels of 25-hydroxyvitamin D[25 (OH) D] in Rheumatoid arthritis(RA) and to assess the association of 25(OH)D with clinical significance.Methods:Serum 25(OH)D levels were detected by enzyme-linked immunosorbent assay(ELISA) in 130 cases with RA and 80 cases with healthy controls.The detail Clinical data of the RA patients were recorded and the relation 25 (OH)D level with clinical indicators, disease activity, bone erosion and the bone mineral density(BMD) of RA patients were analysed.Results: ① Serum levels of 25(OH)D were markedly lower in RA group than control group (17.25±6.24 ng/ml vs 23.17±6.38 ng/ml, P<0.01);② Negative correlation was detected between 25 (OH) D levels and the following :time of morning stiffness, tender joint count(TJc),swollen joint count(SIC),erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), health assessment questionnaire(HAQ) of the patients with RA(both P<0.05);③ 25 (OH) D levels were significantly lower in group midrange and severe of disease activity score in 28 joints which was calculated basd on ESR[DAS28(ESR)] than in group eather inactivity or Low activity (both P<0.05);Insufficiency/deficiency of 25(OH)D is the risk factor of disease activity by the multiple regression analysis(β =-0.136,P< 0.01);④No statistically significant association was observed between 25(OH)D insufficiency/deficiency and bone erosion degree of RA(P>0.05);⑤ Statistically significant differences were found by compared with each group as the following : group of normal BMD, group of osteopenia and group of Osteoporosis(both P <0.01);Enough Serum 25(OH)D level is a protection factor of Osteoporosis in RA by Logistic regression analysis (OR =0.898, 95%CI 0.830-0.972, P<0.01).Conclusions:Significantly low 25(OH)D level was found in patients with RA;Negative correlation was detected between 25 (OH) D level and both disease activity and Osteoporosis in patients with RA.
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