Reumaklinik Danmark, Aalborg University Esbjerg, Havnegade 19, 6700, Esbjerg, Denmark.
Clin Rheumatol. 2013 May;32(5):629-33. doi: 10.1007/s10067-012-2154-6. Epub 2013 Jan 15.
This study aims to measure the serum level of 25-hydroxyvitamin D₃ (25-OH-D₃) in 302 patients with rheumatoid arthritis (RA), studying the association to disease activity. Three hundred two RA patients underwent clinical examination and serological analysis. 25-Hydroxyvitamin D₃ was determined by high-performance liquid chromatography-tandem mass spectrometry. Vitamin D₃ deficiency defined as serum levels of 25-hydroxyvitamin D₃ below 50 nmol/l was detected in 101 RA patients (33.4 %). There was no significant correlation between the serum level of 25-hydroxyvitamin D₃ and Disease Activity Score 28 (DAS28) (3w) score. In a subpopulation of RA patients with very low serum level of 25-OH-D₃ (≤15 nmol/l) (n = 15), there were significant differences compared to patients with normal 25-OH-D3 (n = 200): higher percentage of patients with positive rheumatoid factor (100.0 versus 77.5 %; p = 0.05), higher CRP (28.7 versus 14.8 mg/l; p = 0.001), higher number of patients treated with at least three disease-modifying antirheumatic drugs (DMARDs) (40.0 versus 14.5 %; p = 0.02), higher number of patients with high disease activity DAS28 score of ≥5.1 (20.0 versus 4.5 %; p = 0.01), lower age (54.5 versus 64.0 years; p = 0.003) and shorter disease duration (5.1 versus 10.3 years; p = 0.06). Deficiency of 25-hydroxyvitamin D₃ was detected in 33.4 % of the RA patients. A subpopulation of patients with severe deficiency of vitamin D₃ serum level of ≤15 nmol/l was characterised by all being positive for rheumatoid factor, high percentage of patients with very high disease activity and high percentage of patients treated with at least three DMARDs.
本研究旨在测量 302 例类风湿关节炎（RA）患者的血清 25-羟维生素 D₃（25-OH-D₃）水平，研究其与疾病活动度的相关性。302 例 RA 患者接受了临床检查和血清学分析。采用高效液相色谱-串联质谱法测定 25-羟维生素 D₃。血清 25-羟维生素 D₃水平低于 50 nmol/L 定义为维生素 D₃缺乏症，在 101 例 RA 患者（33.4%）中检测到。血清 25-羟维生素 D₃水平与疾病活动评分 28（DAS28）（3w）评分无显著相关性。在 RA 患者亚群中，血清 25-OH-D₃ 水平非常低（≤15 nmol/L）（n = 15），与血清 25-OH-D₃ 正常（n = 200）患者相比存在显著差异：阳性类风湿因子的患者比例更高（100.0%比 77.5%；p = 0.05），C 反应蛋白（CRP）更高（28.7 比 14.8 mg/L；p = 0.001），至少使用三种疾病改善抗风湿药物（DMARDs）治疗的患者比例更高（40.0%比 14.5%；p = 0.02），疾病活动度 DAS28 评分高（≥5.1）的患者比例更高（20.0%比 4.5%；p = 0.01），年龄更低（54.5 比 64.0 岁；p = 0.003），病程更短（5.1 比 10.3 年；p = 0.06）。RA 患者中 33.4%存在 25-羟维生素 D₃缺乏症。血清 25-羟维生素 D₃ 水平严重缺乏的患者亚群（≤15 nmol/L）的特征是所有患者类风湿因子均为阳性，疾病活动度极高的患者比例较高，且至少使用三种 DMARDs 治疗的患者比例较高。
