25-hydroxy Vitamin D And Rheumatoid Arthritis Study

Background：Rheumatoid arthritis (rheumatoid arthritis, RA) belongs to a chronic systemicautoimmune inflammatory disease, complications may lead to local and systemicbone loss, bone damage, Pathogenesis is unclear so far, most scholars believe itdendritic cells (dendritic cell, DC), B lymphocytes and other abnormalities are related.Vitamin D (vitamin D) is a fat-soluble vitamin, its most representative role is toregulate calcium balance and bone metabolism through the bone, intestine, kidney andparathyroid (parathyroid gland, PT), reduced bone mass loss, prevention ofosteoporosis, reduced the risk of fractures. In recent years, recent studies have foundthat many organizations outside the kidney, liver, bone and other30kinds of organsin the presence and expression of the vitamin D receptor, suggesting a role of vitaminD in a wide range. Therefore, the immune system diseases RA will play a regulatingeffect, however, until this stage, the change of status and its clinical significance inthe serum of patients with RA there is still to be confirmed.Objectives：By enzyme-linked immunosorbent assay (ELISA) method to test RA patientsand healthy controls25-hydroxyvitamin D [25(OH)D] content in serum analyzeddisease activity in patients with RA, bone erosion of the situation inner Relations andbone density, laboratory and clinical covariates (C-reactive protein CRP, rheumatoidfactor RF, cyclic citrullinated peptide CCP, erythrocyte sedimentation rate ESR, etc.)and drug treatment between its RA patients in terms of disease progression the roleplayed by clinical research.Methods：Serum samples were collected Japanese Friendship Hospital Division ofRheumatology RA patients hospitalized in120cases, and80cases of healthy peoplemedical center within the period2013.06-2014.12Jilin University, enzyme-linkedimmunosorbent assay (ELISA) was used to detect serum25(OH)D content, thecorresponding record RA disease activity in patients with DAS28score, duration of morning stiffness, BMD values of bone mineral density, bone erosion of the situation,CRP, RF, CCP, and other information.Results：1. Comparative RA patient group, the serum samples of healthy people in thecontrol group25(OH)D content:120cases of RA patients with serum25(OH)D content and C-reactive protein,anti-CCP and RF are not statistically associated with joint tenderness TJC, number ofswollen joints SJC, duration of morning stiffness and erythrocyte sedimentation rateESR are present negative correlation (P<0.05), described joint tenderness TJC,number of swollen joints SJC, duration of morning stiffness and erythrocytesedimentation rate ESR with25(OH)D levels increase and decrease;2. RA patient serum25(OH)D content with its TJC, SJC, morning stiffness,ESR, CRP, CCP, RF relationship:120cases of RA patients with serum25(OH)D content and C-reactive protein,anti-CCP and RF are not statistically associated with joint tenderness TJC, number ofswollen joints SJC, duration of morning stiffness and erythrocyte sedimentation rateESR are present negative correlation (P <0.05), described joint tenderness TJC,number of swollen joints SJC, duration of morning stiffness and erythrocytesedimentation rate ESR with25(OH)D levels increase and decrease;3.RA patient serum25(OH)D levels associated with disease activity between thetwo:The differences in statistics (P <0.05)120cases of RA patients with differentactivity level25(OH)D content, the performance of28cases of the disease Lowhighest activity group, followed by30cases of the disease moderately active group,62cases of the disease highly active group of25(OH)D was the lowest. Among them,the dependent variable and the independent variables were taken DAS28,25(OH)Dcontent, both of which were gender, age deployment control, multiple regressionanalysis shows statistically significant regression model (F=30.341, P <0.05).25(OH)D levels of partial regression coefficient and95%CI,-0.128(-0.160,-0.096),indicating that serum25(OH)D content on the DAS28negative impact on theperformance of the DAS28score because of25(OH)D increased content is reduced; 4.RA patient’s serum25(OH)D content associated with bone damage:Different degrees of bone erosion25(OH)D content with statistical significance(P <0.05), the performance of25(OH)D maximum level12non-erosive group,followed by48cases of bone erosion group,40cases of severe bone erosion group25(OH)D was the lowest. RA patient group, the bone mineral density in90people,12people is not strange bone mass, bone content of35to reduce the phenomenon ofhuman existence,43people have been diagnosed with symptoms of osteoporosis. Thepresence of three age groups statistically significant (F=26.313, P<0.05), showednormal bone mass youngest, followed by the age group to reduce bone mass,osteoporosis largest group.25(OH)D levels in different BMD group there wassignificant difference (P<0.05), whose25(OH)D content of specific performance (indescending order): normal bone mass, bone mass reduction group, bone osteoporosisgroup.Among them, the dependent variable taking osteoporosis or not; arguments take25(OH)D content, duration and age, around both expand multivariate binary Logisticregression analysis. The results show that age and25(OH)D content on the incidenceof osteoporosis There were significant effect or not (P<0.05), OR95%CI values were1.265(1.105,1.448),0.677(0.552,0.830), indicating that the age is a risk factors fordeveloping the disease; and play a protective role in this disease in the25(OH)Dcontent;5.RA patient serum25(OH)D relationship between content and drug treatment:RA patients before the drug treatment, the number of the latter two groups were32people,58people, they DAS28score,25(OH)D content can not avoid differencesin terms of statistical areas (P<0.05), the performance of drug treatment former groupDAS28score was significantly higher than the drug treatment group,25(OH)D weresignificantly lower than the drug treatment group.In conclusion:1. RA patient group and the control group of healthy people serum25(OH)Dwere significantly different content;2. RA patients with serum25(OH)D content and C-reactive protein, anti-CCPand RF are not statistically associated with joint tenderness TJC, number of swollenjoints SJC, duration of morning stiffness and erythrocyte sedimentation rate ESR arepresent negative correlation; 3. RA patients with serum25(OH)D content increased with the DAS28scoredecreased;4. RA patients with serum25(OH)D content with bone erosion and reduce theaggravation;5. RA patients, older age is a risk factor of osteoporosis, and the high25(OH)Dcontent is a protective factor prevalence of osteoporosis;6RA patient medication DAS28scores before and after treatment, and25(OH)Dwere significantly different content.