Yazmalar L, Ediz L, Alpayci M, Hiz O, Toprak M, Tekeoglu I
Yuzuncu Yil University Medical Faculty, Physical Medicine and Rehabilitation Department. Van. Turkey.
Afr Health Sci. 2013 Mar;13(1):47-55. doi: 10.4314/ahs.v13i1.7.
Vitamin D is a steroid hormone that plays essential roles in calcium and phosphorus metabolism, bone formation and mineralization homeostasis, also has a role in the maintenance of immune-homeostasis.
We aimed to investigate seasonal serum vitamin D levels and seasonal disease activity in patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis.
Seventy-one Rheumatoid Arthritis patients, 72 Ankylosing Spondylitis patients, 74 knee Osteoarthritis patients and 70 healthy controls were recruited for the study. Bi-seasonal measurements of serum 25(OH)D vitamin were checked in either in July or August or September for summertime and either in December or January or February for wintertime. Disease activity were evaluated by Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index, and Western Ontario and McMaster Universities Osteoarthritis Index in groups of Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis respectively.
We did not find any correlation between serum 25(OH)D levels and Disease Activity Score-28, Bath Ankylosing Spondylitis Disease Activity Index, and Western Ontario and McMaster Universities Osteoarthritis Index scores in winter and summer. The difference of Disease Activity Score-28 and Western Ontario and McMaster Universities Osteoarthritis Index scores between winter and summer seasons were not significant in Rheumatoid Arthritis and Osteoarthritis patients (p>0.05). The mean Bath Ankylosing Spondylitis Disease Activity Index score was significantly higher in winter than in summer (p<0.05). Consequently we did not find any correlation between variations of seasonal serum 25(OH)D and the disease activity in the patients with Rheumatoid Arthritis, Ankylosing Spondylitis, and Osteoarthritis.
These results suggest that vitamin D does not have an important role in the seasonal disease activity of these diseases and that seasonal changes in disease activity may play an important role in evaluating Ankylosing Spondylitis patients rather than Rheumatoid Arthritis and Osteoarthritis patients and should be taken into account when examining these patients. These conclusions need to be validated in multicenter studies with high number of patients.
维生素D是一种类固醇激素,在钙和磷代谢、骨形成和矿化稳态中发挥着重要作用,在维持免疫稳态方面也有作用。
我们旨在调查类风湿关节炎、强直性脊柱炎和骨关节炎患者的季节性血清维生素D水平和季节性疾病活动情况。
招募了71名类风湿关节炎患者、72名强直性脊柱炎患者、74名膝关节骨关节炎患者和70名健康对照者进行研究。在夏季的7月或8月或9月以及冬季的12月或1月或2月对血清25(OH)D维生素进行双季测量。分别通过疾病活动评分-28、巴斯强直性脊柱炎疾病活动指数和西安大略和麦克马斯特大学骨关节炎指数对类风湿关节炎、强直性脊柱炎和骨关节炎组的疾病活动进行评估。
我们未发现冬季和夏季血清25(OH)D水平与疾病活动评分-28、巴斯强直性脊柱炎疾病活动指数以及西安大略和麦克马斯特大学骨关节炎指数评分之间存在任何相关性。类风湿关节炎和骨关节炎患者冬季和夏季的疾病活动评分-28以及西安大略和麦克马斯特大学骨关节炎指数评分差异不显著(p>0.05)。冬季的平均巴斯强直性脊柱炎疾病活动指数评分显著高于夏季(p<0.05)。因此,我们未发现类风湿关节炎、强直性脊柱炎和骨关节炎患者季节性血清25(OH)D的变化与疾病活动之间存在任何相关性。
这些结果表明,维生素D在这些疾病的季节性疾病活动中不发挥重要作用,疾病活动的季节性变化在评估强直性脊柱炎患者而非类风湿关节炎和骨关节炎患者时可能起重要作用,在检查这些患者时应予以考虑。这些结论需要在大量患者的多中心研究中得到验证。