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

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

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(P<0.05),且骨侵蚀患者血清25-(OH) D水平低于无骨侵蚀者(P<0.05);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(P<0.05);研究组ff、aa出现频率均低于健康组(P<0.05);血清25-(OH) D<30 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(P<0.05),血清25-(OH) D<20 ng/m L是类风湿性关节炎骨侵蚀的危险因素(P<0.05)。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。

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.