Baskan Bedriye, Oten Erol, Sivas Filiz, Eser Filiz, Yurdakul Fatma Gul, Duran Semra, Bodur Hatice
Ankara Numune Education and Research Hospital.
Acta Reumatol Port. 2016 Oct-Dec;41(4):350-358.
The aim of this study is to investigate the relation between vitamin D levels, vertebral deformities, functional status, quality of life, acute phase reactants and enthesopathy in patients with psoriatic arthritis (PsA).
Fifty-two patients with PsA and 52 controls were enrolled to the study. Routine blood tests and serums 25-(OH)D3 were measured. The thoracic and lumbar vertebrae deformities identified in the radiographies were evaluated by a radiologist. Psoriatic Arthritis Quality of Life (PSAQoL) was used for evaluating quality of life and disease activity parameters for PsA were assessed. In PsA patients, correlations was performed between the 25(OH)-D3 levels and PGE (patient global assessment), PHGE (Physician global assessment), tender JC (joint count), HAQ-S (Health Assessment Questionnaire for the Spondyloarthropathies), PSAQoL, MASES (Maastricht Ankylosing Spondylitis Enthesitis Score) and BASDAI(Bath Ankylosing Spondylitis Disease Activity Index) values.
The results showed that 25(OH)-D3 levels was not correlated with these values. (p>0.05 for r = -0.171, r = -0.167, r=-0.069, r=-0.236, r=-0.062, r= -0.058 and r = -0.106 respectively). It was determined that the PSAQoL score had a positive and statistically significant correlation with the DGD, swollen JC, CRP, HGD, tender JC, VAS-pain, HAQ-S, MASES and BASDAI values in PsA patients. (p>0.05 for r=0.291, r=0.324, r=0.346, r=0.312; and p=0.001 for r=0.472, r=0.380, r=0.565, r=0.696, r=0.359, r=0.633, respectively) Statistical analyses demonstrated that PsA patients with vertebral deformities had higher numbers of tender joints, more prolonged periods of morning stiffness, higher DAS28-ESR (Disease Activity Score) scores, and higher levels of vitamin D (p<0.05, p<0.05, p=0.05 and p<0.05, respectively). The multiple logistic regression analysis indicated that the only factor which had an effect on the development of vertebral deformities was the use of steroids.
This result has demonstrated that psoriatic arthritis has a considerable effect on patient quality of life. Most significant factors that affecting quality of life were physical pain and disability while vertebral deformities and 25-(OH)D3 had no significant effect.
本研究旨在调查银屑病关节炎（PsA）患者的维生素D水平、椎体畸形、功能状态、生活质量、急性期反应物和附着点病之间的关系。
52例PsA患者和52例对照者纳入本研究。进行常规血液检查并测量血清25-(OH)D3。由放射科医生评估X线片中发现的胸腰椎椎体畸形。使用银屑病关节炎生活质量量表（PSAQoL）评估生活质量，并评估PsA的疾病活动参数。在PsA患者中，对25(OH)-D3水平与患者整体评估（PGE）、医生整体评估（PHGE）、压痛关节计数（tender JC）、脊柱关节病健康评估问卷（HAQ-S）、PSAQoL、马斯特里赫特强直性脊柱炎附着点炎评分（MASES）和巴斯强直性脊柱炎疾病活动指数（BASDAI）值进行相关性分析。
结果显示25(OH)-D3水平与这些值无相关性。（r分别为-0.171、-0.167、-0.069、-0.236、-0.062、-0.058和-0.106时，p>0.05）。确定在PsA患者中，PSAQoL评分与DGD、肿胀关节计数（swollen JC）、CRP、HGD、压痛关节计数、视觉模拟评分法疼痛评分（VAS-pain）、HAQ-S、MASES和BASDAI值呈正相关且具有统计学意义。（r分别为0.291、0.324、0.346、0.312时，p>0.05；r分别为0.472、0.380、0.565、0.696、0.359、0.633时，p=0.001）统计分析表明，有椎体畸形的PsA患者压痛关节数更多、晨僵时间更长、疾病活动评分28-红细胞沉降率（DAS28-ESR）更高且维生素D水平更高（分别为p<0.05、p<0.05、p=0.05和p<0.05）。多元逻辑回归分析表明，对椎体畸形发展有影响的唯一因素是使用类固醇。
该结果表明银屑病关节炎对患者生活质量有相当大的影响。影响生活质量的最显著因素是身体疼痛和残疾，而椎体畸形和25-(OH)D3无显著影响。
