PREVALENCE OF 25-HYDROXY VITAMIN D DEFICIENCY AND SOME BIOCHEMICAL PARAMETERS IN IRAQI PATIENTS WITH RHEUMATOID ARTHRITIS AND THEIR ASSOCIATIONS WITH DISEASE ACTIVITY

ABDULNASSER M AL-GEBORI; MOHAMMED HADI MUNSHED ALOSAMI; NAWAL HAIDER AL-HASHIMI

doi:10.22159/ajpcr.2020.v13i4.36759

Authors

ABDULNASSER M AL-GEBORI Department of Applied Science, Branch of Applied Chemistry, University of Technology, Baghdad, Iraq.
MOHAMMED HADI MUNSHED ALOSAMI Department of Medicine, Rheumatology Unit, Colleges of Medicine, University of Baghdad, Baghdad, Iraq.
NAWAL HAIDER AL-HASHIMI Department of Applied Science, Branch of Applied Chemistry, University of Technology, Baghdad, Iraq.

DOI:

https://doi.org/10.22159/ajpcr.2020.v13i4.36759

Keywords:

Rheumatoid arthritis, 25-hydroxy vitamin D, Calcium, Magnesium, Albumin, Aspartate aminotransferase, Alanine aminotransferase

Abstract

Objectives: The objectives of the study were to evaluate changes in 25(OH) Vitamin D levels and some biochemical parameters in rheumatoid arthritis (RA) patients compared with healthy controls and assess the correlation of 25-hydroxy Vitamin D, calcium, magnesium, and disease activity. Study the effects of anti-RA drugs on these biochemical parameters and also the role of supplements calcium and 25-OH Vitamin D in RA patients.

Methods: This study conducted between 60 patients for RA and 20 healthy controls according to the American College of Rheumatology standards in 2010. In this study, 25-hydroxy Vitamin D was measured using an enzyme-linked immunosorbent assay, and also some biochemical parameters were measured with a spectrophotometer (Humalyzer 2000).

Results: Serum 25(OH) Vitamin D, calcium, magnesium, and albumin levels were significantly lower in RA patients compared with healthy controls. Serum alanine aminotransferase aspartate aminotransferase levels were significantly increased in RA patients compared with healthy controls. The correlation was non-significantly among 25-hydroxy Vitamin D and clinical disease activity index (CDAI), while the results showed significantly inverse correlation calcium and magnesium concentrations with CDAI.

Conclusion: 25-OH Vitamin D, calcium, albumin, and magnesium deficiency appear to be widespread in patients with RA. Thus, biochemical changes in RA are reflected in the pathogenesis of RA. Furthermore, in these results, there is no relationship between Vitamin D and the disease activity, while there is a relationship between calcium and magnesium with disease activity.

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References

Tobón GJ, Youinou P, Saraux A. The environment, geo-epidemiology, and autoimmune disease: Rheumatoid arthritis. Autoimmun Rev 2010;9:A288-92.

Wong TH, Gupta ED, Radhakrishnan AK, Gun SC, Chembalingam G, Yeap SS. Effects of 25-hydroxyvitamin D and vitamin D-binding protein on bone mineral density and disease activity in Malaysian patients with rheumatoid arthritis. Int J Rheum Dis 2018;21:992-1000.

Hossein-nezhad A, Holick MF. Optimize dietary intake of Vitamin D: An epigenetic perspective. Curr Opin Clin Nutr Metab Care 2012;15:567-79.

Peters BS, Verly E Jr., Marchioni DM, Fisberg M, Martini LA. The influence of breakfast and dairy products on dietary calcium and Vitamin D intake in postpubertal adolescents and young adults. J Hum Nutr Diet 2012;25:69-74.

Elsammak MY, Al-Wosaibi AA, Al-Howeish A, Alsaeed J. Vitamin D deficiency in Saudi Arabs. Horm Metab Res 2010;42:364-8.

Hossein-Nezhad A, Holick MF. Vitamin D for health: A global perspective. 2013;88:720-55.

Alshahrani AA. Vitamin D Deficiency and Possible Risk Factors among Middle Eastern University Students in London, Ontario, Canada. Electronic Thesis and Dissertation Repository; 2014.

Benkhedda K, L’abbé MR, Cockell KA. Effect of calcium on iron absorption in women with marginal iron status. Br J Nutr 2010;103:742-8.

Gröber U, Schmidt J, Kisters K. Magnesium in prevention and therapy. Nutrients 2015;7:8199-226.

Boyle NB, Lawton C, Dye L. The effects of magnesium supplementation on subjective anxiety and stress-a systematic review. Nutrients 2017;9:429.

Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: Current state of knowledge and future research directions. Nutrients 2013;5:3022-33.

Fanali G, di Masi A, Trezza V, Marino M, Fasano M, Ascenzi P. Human serum albumin: from bench to bedside. Mol Aspects Med 2012;33:209-90.

Boldt J. Use of albumin: An update. Br J Anaesth 2010;104:276-84.

Huang XJ, Choi YK, Im HS, Yarimaga O, Yoon E, Kim HS. Aspartate aminotransferase (AST/GOT) and alanine aminotransferase (ALT/ GPT) detection techniques. Sensors 2006;6:756-82.

Hamad BA. Relationship between Vitamin D3 level and rheumatoid arthritis patients attending Rizgary Teaching Hospital in Erbil city. Zanco J Med Sci 2017;21:1736-42.

Allam NT, El-Wakd MM, El-Abd DM, Dorgham DA. Prevalence of Vitamin D deficiency in Egyptian rheumatoid arthritis patients: Correlation with disease activity, functional disability, and bone mineral density. Egypt Rheumatol Rehabil 2014;41:92.

Weiss ST. Bacterial components plus Vitamin D: The ultimate solution to the asthma (autoimmune disease) epidemic? J Allergy Clin Immunol 2011;127:1128-30.

Hewison M. Vitamin D and immune function: Autocrine, paracrine or endocrine? Scand J Clin Lab Invest Suppl 2012;243:92-102.

Bartels LE, Hvas CL, Agnholt J, Dahlerup JF, Agger R. Human dendritic cell antigen presentation and chemotaxis are inhibited by intrinsic 25-hydroxy Vitamin D activation. Int Immunopharmacol 2010;10:922-8.

Correale J, Ysrraelit MC, Gaitán MI. Immunomodulatory effects of Vitamin D in multiple sclerosis. Brain 2009;132:1146-60.

Song GG, Bae SC, Lee YH. Association between Vitamin D intake and the risk of rheumatoid arthritis: A meta-analysis. Clin Rheumatol 2012;31:1733-9.

Hirani V. Vitamin D status and pain: Analysis from the health survey for England among English adults aged 65 years and over. Br J Nutr 2012;107:1080-4.

Gröber U, Kisters K. Influence of drugs on Vitamin D and calcium metabolism. Dermatoendocrinol 2012;4:158-66.

Davidson ZE, Walker KZ, Truby H. Clinical review: Do glucocorticosteroids alter Vitamin D status? A systematic review with meta-analyses of observational studies. J Clin Endocrinol Metab 2012;97:738-44.

Ahmed MK, Al-Osami MH. Vitamin D Level in Veiled and Unveiled Iraqi Young Females. Baghdad: University of Baghdad; 2017.

Canadian Health Measures Survey. Vitamin D Status of Canadians Vitamin D Nutrients in Milk Products Dairy Nutrition. Dairy Nutrition RSS Government, Canadian Health Measures Survey; 2013.

Kostoglou-Athanassiou I, Athanassiou P, Lyraki A, Raftakis I, Antoniadis C. Vitamin D and rheumatoid arthritis. Ther Adv Endocrinol Metab 2012;3:181-7.

Ringe JD. The effect of Vitamin D on falls and fractures. Scand J Clin Lab Invest Suppl 2012;243:73-8.

Aref IM, Eissa HA, Bayomi IM, Fawzi MM, et al. Relationship between Vitamin D and rheumatoid arthritis activity. Vitam Miner 2017;6:168.

Quraishi MK, Badsha H. Rheumatoid arthritis disease activity and Vitamin D deficiency in an Asian resident population. Int J Rheum Dis 2016;19:348-54.

Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of Vitamin D in rheumatoid arthritis and its correlation with disease activity. J Nat Sci Biol Med 2018;9:54-8.

Makhdoom A, Rahopoto MQ, Laghari MA, QureshiPir AL, Siddiqui KA. Bone mineral levels in rheumatoid arthritis. Med Channel 2009;15:99-102.

Chavan VU, Ramavataram D, Patel PA, Rupani MP. Evaluation of serum magnesium, lipid profile and various biochemical parameters as risk factors of cardiovascular diseases in patients with rheumatoid arthritis. J Clin Diagn Res 2015;9:BC01-5.

Hoenderop JG, Nilius B, Bindels RJ. Calcium absorption across epithelia. Physiol Rev 2005;85:373-422.

Walwadkar SD, Suryakar AN, Katkam RV, Kumbar KM, Ankush RD. Oxidative stress and calcium-phosphorus levels in rheumatoid arthritis. Indian J Clin Biochem 2006;21:134-7.

Reid DM, Kennedy NS, Smith MA, Tothill P, Nuki G. Total body calcium in rheumatoid arthritis: Effects of disease activity and corticosteroid treatment. Br Med J (Clin Res Ed) 1982;285:330-2.

Suzuki T, Nakamura Y, Kato H. Calcium and Vitamin D supplementation with 3-year denosumab treatment is beneficial to enhance bone mineral density in postmenopausal patients with osteoporosis and rheumatoid arthritis. Ther Clin Risk Manag 2019;15:15-22.

Yilmaz L, Ozoran K, Gündüz OH, Uçan H, Yücel M. Alendronate in rheumatoid arthritis patients treated with methotrexate and glucocorticoids. Rheumatol Int 2001;20:65-9.

Lucia M, Isabela S, Minerva G. Changes of serum magnesium level in patients with rheumatoid arthritis stage I-II before treatment. Med Conn 2011;6:9-16.

Cortés YE, Moses L. Magnesium disturbances in critically ill patients. Compend Contin Educ Vet 2007;29:420-7.

Koo BS, Hong S, Kim YJ, Kim YG, Lee CK, Yoo B. Clinical characteristics of patients with rheumatoid arthritis who have sustained high erythrocyte sedimentation rates after clinical remission. J Rheum Dis 2014;21:21-24.

Wilkinson P, Jeremy R, Brooks FP, Hollander JL. The mechanism of hypoalbuminemia in rheumatoid arthritis. Ann Intern Med 1965;63:109-14.

Curtis JR, Beukelman T, Onofrei A, Cassell S, Greenberg JD, Kavanaugh A, et al. Elevated liver enzyme tests among patients with rheumatoid arthritis or psoriatic arthritis treated with methotrexate and/or leflunomide. Ann Rheum Dis 2010;69:43-7.

Limdi JK, Hyde GM. Evaluation of abnormal liver function tests. Postgrad Med J 2003;79:307-12.