| Objective:By detecting the expression of serum 25-hydroxy vitamin D[25(OH)D] and interleukin 38(IL-38)in rheumatoid arthritis(RA).Analyzing the correlation between 25(OH)D and IL-38 and the clinical,serological and imaging indicators of RA.To explore the possibility that 25(OH)D and IL-38 may affect the disease activities of RA by participating in immune regulation.Methods: Sixty-three newly diagnosed RA patients hospitalized in the Rheumatology Department of The Affiliated Hospital of Guilin Medical University from September 2020 to December 2021 were included in this study.According to different conditions,RA patients were divided into different subgroups.Age,sex,body mass index(BMI),morning stiffness time,course of disease,swollen joints count(SJC),tender joints count(TJC),DAS28,anti-cyclic citrulline antibody(anti-CCP),rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),albumin(ALB)and globulin(GLO),serum calcium,immunoglobulin(Ig M,Ig A,Ig G),complement(C3,C4),T cell subsets,lymphocyte subsets,bone mineral density(BMD,Z/T value),articular musculoskeletal ultrasound(MSUS)results and other indicators were collected.Healthy people who underwent physical examination in the Health Examination Center of The Affiliated Hospital of Guilin Medical University during the same period were selected as the healthy control group,and the indexes such as age,sex,BMI,ALB,GLo,anti-CCP and RF were collected.At the same time,the serum samples were collected and the serum levels of 25(OH)D,IL-1β,IL-6,IL-17,IL-38 and TNF-α were detected by ELISA.Results:(1)Compared with HC group,the level of 25(OH)D in RA group was significantly lower,and the difference was statistically significant(P< 0.05);the expression levels of IL-1β,IL-6,IL-17,IL-38 and TNF-α were significantly increased,the differences were statistically significant(P < 0.05).(2)RA patients were divided into three different subgroups according to DAS28.There were statistically significant differences in 25(OH)D,IL-6,IL-17,IL-38,TNF-α,BMD,Z/T value,blood flow signal score and synovium signal score among the three groups(P < 0.05).The expression levels of 25(OH)D,IL-38,BMD and Z/T decreased.The expression levels of IL-6,IL-17,TNF-α,blood flow signal score and synovial signal score increased.(3)There were no significant differences in the expression levels of 25(OH)D and IL-38 between anti-CCP negative group and anti-CCP positive group,RF negative group and RF positive group,and non-osteoporosis group and osteoporosis group(P >0.05).(4)RA patients were divided into three different subgroups according to25(OH)D level.TJC,SJC,DAS28,CRP,(CD3+CD4+CD8+)cells,IL-1β,IL-6,IL-17,IL-38,TNF-α,blood flow signal score and synovial signal score expression levels were significantly different among the three groups(P < 0.05).With the decrease of 25(OH)D level,the expression levels of BMD decrease,the expression levels of DAS28,CRP,TNF-α,IL-1β,IL-6 and IL-17 increased.(5)In RA group,25(OH)D was negatively correlated with TJC,DAS28,serum calcium,ESR,CRP,TNF-α,IL-1β,IL-6,IL-17,blood flow signal score,synovial signal score;and positively correlated with IL-38,BMD,Z/T value,with statistical significance(P < 0.05).(6)IL-38 was negatively correlated with TJC,SJC,DAS28,IL-6 and IL-17 in RA group,and the differences were statistically significant(P < 0.05).Conclusions:(1)The expression level of 25(OH)D in RA group was significantly lower than that in healthy control group,and was negatively correlated with the disease activity index and IL-1β、IL-6、IL-17、TNF-α of RA,suggesting that RA patients are more prone to vitamin D deficiency than healthy people.25(OH)D may affect the disease activity of RA by inhibiting the secretion of inflammatory factors.(2)The expression level of IL-38 in RA group was significantly higher than that in healthy control group,and was negatively correlated with disease activity index,IL-6 and IL-17 in RA group.These results suggest that IL-38 may play an anti-inflammatory role in RA and influence the disease activity of RA. |
