Study On The Relationship Between Serum 25-hydroxy Vitamin D And Lymphocyte Subsets In Patients With Rheumatoid Arthritis

Objective: By detecting the levels of 25-hydroxy vitamin D and lymphocyte subsets in peripheral blood of patients with rheumatoid arthritis(RA),To investigate(1)the changes of 25-hydroxy vitamin D levels in peripheral blood of patients with RA and their association with the disease activity index;(2)The changes of lymphocyte subsets in peripheral blood of patients with RA;(3)the relationship between the levels of 25-hydroxy vitamin D and lymphocyte subsets,so as to find a possible pathogenesis and new way for the treatment of RA.Methods: Cases were selected in July 2014 to December 2015 in Tangshan worker hospital,55 RA patients,including 46 cases of female,9 males,age 24-76,average age(57.2±10.1).47 healthy controls were from Tangshan worker hospital health examination,39 cases of female,8 males,aged 26-76 years old,average(52.9±12.3)years old.Both groups were extracted A,B 2 tube blood of 4ml in the next morning.A tube was used for detection of 25-hydroxy vitamin D by chemiluminescence micro particle immunoassay,B tube was used for detection of lymphocyte subsets by flow cytometry.And the duration of the case group patients,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),disease activity(DAS28)scores and other diseases related indicators were collected.The changes of 25-hydroxy vitamin D and lymphocyte subsets between two groups were studied by correlation analysis.Results: 1 Comparison of serum 25-hydroxy vitamin D between two groups: Case group(13.46±5.82)was significantly lower than control group(18.95±6.03),the difference was statistically significant(P=0.000);2 The level of serum 25-hydroxy vitamin D decreased in cases,which was significantly negatively correlated with CRP and ESR,and the difference was statistically significant(r=-0.268,P=0.048;r=-0.360,P=0.007).The duration,RF and DAS28 score were no significant correlation(r = 0.092,P = 0.503;r = 0.162,P = 0.238;r =-0.072,P = 0.603).The case group was divided into two subgroups by Anti-CCP antibody.In the anti-CCP antibody positive group,25-hydroxy vitamin D levels average(13.68±6.03)ng/ml,In the negative group,average(11.98±4.20)ng/ml,there was no significant difference between the two groups,P=0.476;3 Comparison of lymphocyte subsets in case and control groups: The number of T cells(CD3~+)was decreased,but the difference was not statistically significant,P=0.132;Th cells(CD3~+,CD4~+)number significantly increased,the difference was statistically significant,P= 0.014;Ts cells(CD3~+,CD8~+)number lower,the difference was statistically significant,P= 0.000;Th/Ts ratio increased,the difference was statistically significant,P = 0.000;B cells(CD19~+),NK cells(CD3-,CD16 ~+ CD56 ~+)were increased quantity,but there was no statistically significant,P = 0.328,P = 0.431 respectively;4 Correlation between 25-hydroxy vitamin D and lymphocyte subsets in case group: Serum 25-hydroxy vitamin D and T cells(CD3~+),Th cells(CD3~+,CD4 ~+),B cells(CD19~+),NK cells(CD3-,CD16~+ CD56~+)have no significant correlation(r = 0.250,P = 0.065;r =-0.024,P = 0.861;r =-0.047,P = 0.735;r =-0.061,P = 0.657 respectively);25-hydroxy vitamin D and Ts cells(CD3~+,CD8~+)have a positive correlation,the difference was statistically significant(r=0.459,P=0.000);And with Th/Ts ratio into a significant negative correlation,the difference was statistically significant(r=0.-0.353,P=0.008).Conclusions:1 The level of serum 25-hydroxy vitamin D in RA patients was significantly lower than that in healthy control group,and was related to the disease activity index.2 RA is a kind of autoimmune disease,and its lymphocyte subsets are obviously abnormal,especially Th/Ts ratio increased significantly.3 There is a certain correlation between serum 25-hydroxy vitamin D and lymphocyte subsets in patients with RA,suggesting that the incidence of RA may be related to the deficiency of vitamin D.