血清25-(OH)D水平及VDR基因多态性与类风湿性关节炎骨侵蚀的关系探讨

目的探讨血清25-羟维生素D[25-(OH) D]及维生素D受体(vitamin D receptor,VDR)基因多态性与类风湿性关节炎骨侵蚀的关系。方法将94例类风湿性关节炎患者设为研究组,另将85名健康体检者设为健康组。2组均检测血清25-(OH) D水平,且提取基因组DNA,采用MassARRAY分子量阵列技术平台检测VDR基因多态性,分析其与类风湿性关节炎骨侵蚀度之间的关系。结果研究组血清25-(OH) D水平低于健康组(P0.05),且骨侵蚀患者血清25-(OH) D水平低于无骨侵蚀者(P0.05);研究组Fok I位点基因型FF、Ff及等位基因F和Apa I位点基因型AA、Aa及等位基因A频率均高于健康组(P0.05);研究组ff、aa出现频率均低于健康组(P0.05);血清25-(OH) D30 ng/m L、Fok I位点基因型FF及Ff、Apa I位点基因型AA及Aa均是类风湿性关节炎发病的危险因素(P0.05),血清25-(OH) D20 ng/m L是类风湿性关节炎骨侵蚀的危险因素(P0.05)。结论血清25-(OH) D水平缺乏可增加类风湿性关节炎骨侵蚀发生风险,VDR基因Fok I位点等位基因F及Apa I位点等位基因A可增加类风湿性关节炎发病风险,但与骨侵蚀无关。

Relationship among serum 25- (OH) D level, VDR gene polymorphism, and bone erosion in patients with rheumatoid arthritis

Objective To explore the relationship among serum 25-hydroxyvitamin D [25-(OH)D], vitamin D receptor (VDR) gene polymorphism, and bone erosion in patients with rheumatoid arthritis. Methods Ninety-four patients with rheumatoid arthritis were divided into study group and 85 healthy persons were divided into health group. The serum 25- (OH)D levels were detected in the 2 groups. The genomic DNA was extracted and the VDR gene was detected using MassARRAY molecular weight array technology platform. The relationship between serum 25-(OH)D level and VDR gene polymorphism and bone erosion in rheumatoid arthritis was analyzed. Results The serum 25-(OH)D level in the study group was significantly lower than that in the healthy group (P<0.05), and it was lower in the patients with bone erosion than in the patients without bone erosion (P<0.05). The frequencies of genotype FF, Ff, and allele F of FokI locus and genotype AA, and allele A of ApaI locus in the study group were significantly higher than those in the healthy group (P<0.05). The frequencies of genotype ff and aa in the study group were significantly lower than those in the healthy group (P<0.05). Serum 25-(OH) D less than 30 ng/mL, FokI genotype FF and Ff, and ApaI genotype AA and Aa were risk factors for rheumatoid arthritis (P < 0.05). Serum 25-(OH)D less than 20 ng/mL was a risk factor for bone erosion in rheumatoid arthritis (P<0.05). Conclusion Lack of serum 25-(OH)D increases the risk of bone erosion in patients with rheumatoid arthritis. The allele F of FokI and the allele of ApaI of VDR gene increase the risk of rheumatoid arthritis, but VDR gene is not associated with bone erosion.