Alharbi Samar, Alharbi Razan, Alhabib Enas, Ghunaim Reenad, Alreefi Mawadah M
Department of Medicine, College of Medicine, Taibah University, Medina, SAU.
Cureus. 2023 Feb 9;15(2):e34815. doi: 10.7759/cureus.34815. eCollection 2023 Feb.
Background Epidemiological studies indicate that vitamin D deficiency may increase the risk of developing autoimmune and chronic diseases such as rheumatoid arthritis (RA) and, therefore, is prevalent in patients with RA. Additionally, vitamin D insufficiency is associated with significant disease activity in patients with RA. This study aimed to assess the prevalence of vitamin D deficiency in Saudi patients with RA and determine whether there is an association between low vitamin D levels and RA disease activity. Methodology This cross-sectional retrospective study was conducted from October 2022 to November 2022 on patients who attended the rheumatology clinic at King Salman bin Abdulaziz Medical City, Medina, Saudi Arabia. Patients aged ≥18 years, diagnosed with RA, and not on vitamin D supplements were included. Demographic, clinical, and laboratory data were collected. Disease activity was measured using the disease activity score index of a 28-joint count using the erythrocyte sedimentation rate (DAS28-ESR). Results In total, 103 patients were included, with 79 patients being women (76.7%) and 24 being men (23.3%). The vitamin D level ranged from 5.13 to 94 ng/mL, with a median of 24. Of the studied cases, 42.7% had insufficient vitamin D levels, 22.3% had a deficiency, and 15.5% had severe deficiency. There were statistically significant correlations between the median vitamin D level and C-reactive protein (CRP), the number of swollen joints, and DAS. A lower median vitamin D level was detected among cases with positive CRP, swollen joints >5, and higher disease activity. Conclusions Patients with RA in Saudi Arabia were more likely to have low vitamin D levels. Moreover, vitamin D deficiency was linked to disease activity. Therefore, the measurement of vitamin D levels in patients with RA is essential, and vitamin D supplements might be important to improve disease outcomes and prognoses.
背景 流行病学研究表明,维生素D缺乏可能会增加患自身免疫性疾病和慢性疾病(如类风湿性关节炎,简称RA)的风险,因此在RA患者中很普遍。此外,维生素D不足与RA患者的显著疾病活动相关。本研究旨在评估沙特RA患者中维生素D缺乏的患病率,并确定维生素D水平低与RA疾病活动之间是否存在关联。
方法 本横断面回顾性研究于2022年10月至2022年11月对在沙特阿拉伯麦地那国王萨勒曼·本·阿卜杜勒阿齐兹医疗城风湿病诊所就诊的患者进行。纳入年龄≥18岁、诊断为RA且未服用维生素D补充剂的患者。收集人口统计学、临床和实验室数据。使用基于红细胞沉降率的28关节计数疾病活动评分指数(DAS28-ESR)测量疾病活动度。
结果 总共纳入了103名患者,其中79名女性(76.7%),24名男性(23.3%)。维生素D水平范围为5.13至94 ng/mL,中位数为24。在研究病例中,42.7%的患者维生素D水平不足,22.3%的患者维生素D缺乏,15.5%的患者维生素D严重缺乏。维生素D中位数水平与C反应蛋白(CRP)、肿胀关节数量和DAS之间存在统计学显著相关性。在CRP阳性、肿胀关节>5个和疾病活动度较高的病例中,检测到较低的维生素D中位数水平。
结论 沙特阿拉伯的RA患者更有可能维生素D水平较低。此外,维生素D缺乏与疾病活动有关。因此,测量RA患者的维生素D水平至关重要,补充维生素D可能对改善疾病结局和预后很重要。