| Rheumatoid arthritis（RA）is a common autoimmune disease characterized by symmetry,progressive and aggressive arthritis,with a high rate of disability and mortality.The prevalence rate of the world population is 0.5%1.0%,and its pathogenesis has not been elucidated.Recent studies have shown that its pathogenesis may be related to the disruption of immune balance.Vitamin D（VitD）is a liposoluble steroid derivative,which has been found to have more and more biological functions,which are involved in tumor,endocrine,immunity and so on.Increasing studies have found that VitD is associated with a variety of autoimmune diseases,such as systemic lupus erythematosus,and so on,which plays an important regulatory role in the immune system.Patients with RA often have VitD deficiency which is related to disease activity and severity.VitD can also regulate the pathophysiological process of RA.VitD level is related to the pathogenesis and development of RA.Whether supplementation of VitD can be used as an adjuvant therapy to control the occurrence and development of RA is rarely reported in China.If VitD is involved in the pathogenesis of RA and can be used as a breakthrough in the treatment of RA,it will have a significant impact on the prevention and treatment of RA.Objective:Serum 1,25-hydroxyvitamin D3（1,25（OH）2D3）is the main product of vitamin D（Vitamin D,Vit D）,which can show the absolute content of active VitD in vivo.This study by detecting rheumatoid arthritis（RA）patients with serum 1,25（OH）2D3 level,serum 1,25（OH）2D3 level and the correlation of illness and disease activity RA,explore 1,25（OH）2D3 role in the pathogenesis of RA,for the treatment of RA provides more security,economic and effective new solutions.Methods:From June 2017 to October 2017,we collected 50 cases of RA patients in rheumatoid immunology department in Hebei Medical University second hospital with clinical data and laboratory data,all cases diagnosed clear,complete clinical data.At the same time,38 patients were selected as healthy control group.Hospitalized patients with RA patients admitted to hospital or health check-up before to collect general information:including ethnic,past history,smoking history,family history,gender,age,blood pressure,duration,height,weight,number of active arthritis of the number,the affected organ,tenderness joint number,tenderness,number of joints,restricted movement joints,calculate body mass index（BMI）and hormone,hydroxychloroquine sulfate,the usage of immunosuppressant,etc.All subjects received informed consent from the guardian and signed informed consent.The subjects were venous blood,and measured the levels of ESR,CRP,WBC,RBC,BGP,alkaline phosphatase,blood calcium and blood phosphorus in serum.The serum 1,25（OH）2D3 level and calcitonin（BGP）levels of all subjects in the experimental group and healthy control group were detected by colloidal gold immunochromatography.The rheumatoid factor（RF）level was detected by enhanced immunotur-bidimetry.The anti-ccp antibody level in the sample was determined by the two-antibody sandwich enzyme immunoassay.The clinical activity evalu-ation of patients with RA was evaluated by using the DAS28 efficacy standard developed by EULAR.Results:1.RA experimental serum1,25（OH）2D3 levels（24.64±3.89）nmol/L,healthy controls serum1,25（OH）2D3 levels（30.21±4.14）nmol/L,RA experimental serum 1,25（OH）2D3 levels significantly lower than that of healthy controls,the difference was statistically significant（P=0.003）;2.RA experimental serum BGP level（5.114±0.09）ng/L,healthy controls serum BGP level（8.334±0.01）ng/L,RA serum BGP level was significantly lower than healthy controls,the difference was statistically significant（P=0.024）;3.Serum 1,25（OH）2D3 level of RA patients was closely related to serum anti-ccp antibody（t=1.472,P=0.044）,ESR（t=1.283,P=0.002）and alkaline phosph-atase（t=0.978,P=0.037）.4.The bone erosion score of Sharp score in RA group was（3.87±0.79）.Pearson correlation analysis showed that 1,25（OH）2D3was significantly correlated with Sharp bone erosion and bone stenosis（P=0.008）.5.Pearson correlation analysis showed that 1,25（OH）2D3 was signi-ficantly correlated with DAS28’s clinical activity（r=0.093,P=0.025）.Conclusions:1.Serum VitD level was significantly reduced in RA patients,and decreased serum VitD content may be related to the occurrence of RA;2.The serum BGP level of RA patients was significantly reduced,and the decrease of serum BGP content may be related to the occurrence of RA.3.Serum VitD and BGP levels may promote the occurrence of RA together. |
