Vitamin D'nin romatoid artrit üzerindeki etkisi: gerçek mi yoksa sadece hasta algısı mı?

Öz

Amaç: Bu çalışmadaki amaçlarımız, romatoid artrit (RA) hastalarında D vitamini düzeylerini ve D vitamini düzeylerinin objektif ve subjektif değerlendirmelere etkisini belirlemektir.

Yöntemler: Bu çalışma, 108 RA hastası ve yaş ve cinsiyete göre eşleştirilmiş 50 sağlıklı kontrol üzerinde yapılan bir prospektif olgu-kontrol çalışmasıdır. Öncelikle RA hastaları ve kontroller arasında D vitamini düzeylerini karşılaştırdık. RA hastalarının demografik ve klinik verileri, hastalık aktivitesi parametreleri, inflamatuvar belirteçleri, romatoid faktör ve anti-siklik sitrüllenmiş peptid seropozitifliği ve radyolojik hasar skorları kaydedildi. Hastalardan ayrıca RA Yaşam Kalitesi Anketi (Rheumatoid Arthritis Quality of Life, RAQoL), yorgunluk şiddet ölçeği (Fatigue Severity Scale, FSS) ve Sağlık Değerlendirme Anketi (Health Assessment Questionnaire, HAQ) tamamlamaları istendi.

Bulgular: RA hastalarında D vitamin düzeyleri sağlıklı kontrollerden anlamlı derecede düşüktü (p=0,001). RA hastalarının % 73'ünde ve kontrollerin % 52'sinde D vitamini eksikliği tespit edildi. D vitamini eksikliği, hastalık aktivitesi ile ilişkili değildi (p=0,862). D vitamini seviyeleri ile tüm subjektif ve objektif değerlendirmeler arasında anlamlı bir ilişki bulunamadı (hepsi için p>0,050).

Sonuç:  D vitamini eksikliği RA hastalarında normal popülasyona göre daha sık görülmektedir.  Ancak, vitamin D düzeyleri ile hastalık aktivitesi, inflamatuvar belirteçler, romatoid faktör ve anti-siklik sitrüllenmiş peptid seropozitifliği, radyolojik hasar skorları ve RAQoL, FSS, HAQ ile ilişkili hastalığın objektif ve subjektif değerlendirmeleri arasında anlamlı bir ilişki bulunduğu gösterilemedi.

Anahtar Kelimeler

• Romatoid Artrit,D vitamini,radyolojik hasar

Impact of vitamin D on rheumatoid arthritis: real or just patient’s perception?

Abstract

Aim: In this study, our aims were to identify vitamin D levels in rheumatoid arthritis (RA) individuals as compared to controls and the impact of vitamin D levels on both objective and subjective assessments in RA patients.

Methods: The current study was a prospective case-control study conducted on 108 RA patients and 50 age-gender matched healthy controls. We first compared the levels of vitamin D among the RA patients and controls. Demographic and clinical data, parameters of disease activity, inflammatory markers, rheumatoid factor and anti-cyclic citrullinated peptide seropositivity and radiological damage scores were recorded in RA patients. These patients were also demanded to complete RA Quality of Life Questionnaire (RAQoL), fatigue severity scale (FSS)  and Health Assessment Questionnaire (HAQ).

Results: D vitamin levels in RA patients were significantly lower than healthy controls (p=0.001). Vitamin D deficiency was determined in 73% of the RA patients and 52% of the controls. Vitamin D deficiency was not associated with disease activity (p=0.862). There was no significant relationship among vitamin D levels and all subjective and objective assessments (p>0.05 for all ).

Conclusion: Vitamin D deficiency was common in RA participants than normal population. However, it was not shown that there was a significant relationship between vitamin D levels and objective and subjective assessments of disease, including disease activity, inflammatory markers, rheumatoid factor and anti-cyclic citrullinated peptide seropositivity, radiological damage scores, RAQoL, FSS and HAQ.

Keywords

• Rheumatoid Arthritis,Vitamin D,radiological damage

Kaynakça

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