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目的探讨患者外周血维生素D(VD)及其受体(VDR)水平与类风湿关节炎(RA)活动度的关系。方法检测RA患者(RA组)和43例健康人(对照组)血清25-羟基维生素D[25(OH)D]水平,PCR检测外周血单个核细胞中VDR mRNA表达,分析其与C反应蛋白、血沉、类风湿因子、抗环瓜氨酸肽抗体及疾病活动度评分(DAS28)的相关性。结果 RA组血清25(OH)D水平(36.4±1.9)nmol/ml,低于对照组的(42.5±2.0)nmol/ml(P<0.05)。RA疾病高度活动组血清25(OH)D水平低于中低度活动组,且血清25(OH)D水平与CRP和ESR呈负相关(r=-0.31和-0.38,P<0.05)。RA患者外周血VDR mRNA表达低于对照组(P<0.01)。结论 RA患者外周血VDR水平显著降低,且与疾病活动相关,提示VD及VDR通路可能参与RA病理过程。
Objective To investigate the relationship between the level of vitamin D (VD) and its receptor (VDR) in peripheral blood and the activity of rheumatoid arthritis (RA). Methods Serum levels of 25-hydroxyvitamin D [25 (OH) D] in RA patients (RA group) and 43 healthy volunteers (control group) were measured. VDR mRNA expression in peripheral blood mononuclear cells was detected by PCR and analyzed with C-reactive protein , ESR, rheumatoid factor, anti-cyclic citrullinated peptide antibody and disease activity score (DAS28). Results The serum 25 (OH) D level in RA group was significantly lower than that in control group (36.4 ± 1.9) nmol / ml (42.5 ± 2.0) nmol / ml (P <0.05). Serum 25 (OH) D levels were significantly lower in patients with high activity of RA disease than those in low and middle activity groups, and serum 25 (OH) D levels were negatively correlated with CRP and ESR (r = -0.31 and -0.38, P <0.05). The expression of VDR mRNA in peripheral blood of RA patients was lower than that of the control group (P <0.01). Conclusion The VDR level in peripheral blood of patients with RA is significantly lower than that in patients with RA, which is correlated with disease activity, suggesting that VD and VDR pathways may be involved in the pathogenesis of RA.