| Objective: This study measured 25(OH)D3 level in peripheral blood and bone mineral density(BMD) of middle-lower one third of left forearms in rheumatoid arthritis(RA) patients. Based on the variations in plasma 25(OH)D3 concentrations and BMD in RA patients from different groups, this study investigated the pathogenesis of rheumatoid arthritis(RA) and the correlation of between RA severity and 25(OH)D3 concentration as well as BMD, providing evidence for diagnosis and treatment of RA.Methods: We collected peripheral blood in 82 RA patients received by outpatient and inpatient rheumatology department in Affiliated Hospital of North Sichuan Medical College from July 2014 to August 2015, as well as in 52 healthy individuals. Based on the variations in manifestations and stages of RA patients phalanx X-ray photographs, patients were divided into 4 groups, with 22 cases in Group I, 29 cases in Group II, 19 cases in Group III and 12 cases in group IV. The plasma 25(OH)D3 levels in peripheral blood were detected via ELISA. In addition, EXA-3000 dual energy X-ray absorptionmetry was used to measure the BMD of middle-lower one third of left forearms in RA patients and healthy individuals. The variations in plasma 25(OH)D3 level and BMD in patients of different groups and their significances were comparatively analyzed. The correlation between RA and plasma 25(OH)D3 level as well as BMD in RA patients were discussed.Results:1. RA group had a 25(OH)D3 concentration of(23.51±3.02)ng/ml which was markedly lower than that of the control group(26.25±3.74)ng/ml. The difference was statistically significant(P<0.05); the BMD of RA group was(0.329±0.072)g/cm2 which was significantly lower than that of the control group(0.465±0.065)g/cm2(P<0.05).2. The 25(OH)D3 concentrations of Group I, II, III, IV and the healthy control group were(26.06±4.05)ng/ml,(20.45±3.38)ng/ml,(17.37±2.88)ng/ml,(14.01±2.45)ng/ml,(26.25±3.74)ng/ml, respectively. There was no significant difference(P>0.05) between Group I and control group in terms of 25(OH)D3 concentration. The 25(OH)D3 concentrations of Group II, III, IV were significantly lower than that of control group(P<0.05). Paired comparisons were conducted among RA patients in Group I, II, III and IV. Group IV had a significantly lower 25(OH)D3 concentration than Group III(P<0.05). 25(OH)D3 concentration in Group III was significantly lower than Group I and Group II(P<0.05). Group II had a significantly lower 25(OH)D3 concentration than Group I(P<0.05).3. BMDs of Group I, II, III, IV and the healthy control group were(0.457±0.061)g/cm2,(0.318±0.035)g/cm2,(0.297±0.049)g/cm2,(0.235±0.024) g/cm2,(0.465±0.065)g/cm2, respectively. There was no significant difference between BMD of Group I and control group(P>0.05). The BMD of Group II, III, IV was significantly lower than control group(P<0.05). Paired comparisons were conducted among RA patients in Group I, II, III and IV. Group IV was significantly lower than Group III(P<0.05) in terms of BMD. Group III had a significantly lower BMD than Group I and Group II(P<0.05). BMD of Group II was significantly less than Group I(P<0.05).4. 25(OH)D3 concentration in peripheral blood of RA patients decreases while the severity of disease increases, which represented a negative correlation with correlation coefficient r=-0.72. The correlation was statistically significant(P<0.05). BMD in RA patients decreases with increase of disease severity which represented a negative correlation with correlation coefficient r=-0.63. The correlation was statistically significant(P<0.05). The 25(OH)D3 concentration in peripheral blood in RA patients had a positive correlation with BMD with a correlation coefficient of 0.67. The correlation was statistically significant(P<0.05).Conclusion:1. 25(OH)D3 concentration in peripheral blood and BMD of RA patients markedly decreased compared to control group which indicated that 25(OH)D3 may involve in the development and progression of RA.2. As RA severity increases, 25(OH)D3 level and BMD in patients gradually decrease. Furthermore, 25(OH)D3 level is positively correlated with BMD. 25(OH)D3 level and BMD may become the indices for assessing the severity of RA.3. Predictions were made that taking vitamin D may help to suppress autoimmune responses, relieve acute conditions of RA and delay disease development. |
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