Yesil Hilal, Sungur Ulas, Akdeniz Sedef, Gurer Gulcan, Yalcın Basak, Dundar Umit
Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University Faculty of Medicine, Afyon, Turkey.
Department of Physical Medicine and Rehabilitation, Ege University Faculty of Medicine, Izmir, Turkey.
Int J Rheum Dis. 2018 Feb;21(2):431-439. doi: 10.1111/1756-185X.13160. Epub 2017 Aug 31.
Recent literature suggests that neuropathic pain (NP) and vitamin D deficiency can occur concurrently in patients with rheumatoid arthritis (RA). This study aimed to examine the development of NP in patients with RA and the relationship between NP and vitamin D.
We used the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) questionnaire to evaluate NP in 93 patients with RA. Demographic and clinical data were obtained from patient files and interviews, and patients' serum vitamin D levels were recorded. Patients were requested to complete both the Short Form-36 survey and the Health Assessment Questionnaire.
Seventy-five of the eligible patients were female (80.6%), and 31 (33.3%) were diagnosed with NP according to the LANSS. There was a negative correlation between vitamin D levels and the LANSS score (P = 0.001). The prevalence of NP was 5.8 times higher among patients with serum vitamin D levels below 20 ng/mL than in patients with vitamin D levels ≥ 30 ng/mL. Based on the area under curve (AUC) values, we found that serum levels of vitamin D were a good predictor of NP diagnoses in patients with RA (AUC = 0.71).
We found that vitamin D deficiency was asssociated with increased NP in patients with RA. Although further research is needed to clarify the association between serum vitamin D levels and NP, our study raises awareness of the need to screen for vitamin D deficiency in RA patients with NP.
近期文献表明，类风湿关节炎（RA）患者可能同时出现神经性疼痛（NP）和维生素D缺乏。本研究旨在探讨RA患者中NP的发生情况以及NP与维生素D之间的关系。
我们使用利兹神经病理性症状和体征评估（LANSS）问卷对93例RA患者的NP进行评估。从患者病历和访谈中获取人口统计学和临床数据，并记录患者的血清维生素D水平。要求患者同时完成简短健康调查量表（SF-36）和健康评估问卷。
符合条件的患者中75例为女性（80.6%），根据LANSS评估，31例（33.3%）被诊断为NP。维生素D水平与LANSS评分呈负相关（P = 0.001）。血清维生素D水平低于20 ng/mL的患者中NP患病率比维生素D水平≥30 ng/mL的患者高5.8倍。根据曲线下面积（AUC）值，我们发现血清维生素D水平是RA患者NP诊断的良好预测指标（AUC = 0.71）。
我们发现维生素D缺乏与RA患者NP增加有关。尽管需要进一步研究来阐明血清维生素D水平与NP之间的关联，但我们的研究提高了对NP的RA患者筛查维生素D缺乏必要性的认识。
