Correlations between serum 25-hydroxy vitamin D, interleukin-23, coagulation function indicators and the severity of rheumatoid arthritis and treatment effect
10.3760/cma.j.cn341190-20240208-00167
- VernacularTitle:血清25-羟-维生素D、白细胞介素23及凝血功能指标与类风湿关节炎病情程度及治疗效果的相关性研究
- Author:
Ru LIU
1
;
Huanli YANG
;
Minjie ZHANG
Author Information
1. 咸阳市中心医院全科医学科，咸阳 712000
- Keywords:
Arthritis, rheumatoid;
25-Hydroxyvitamin D2;
Interleukin-23;
Prothrombin time;
Partial thromboplastin time;
Severity of illness index;
Fibrinogen
- From:
Chinese Journal of Primary Medicine and Pharmacy
2024;31(7):1037-1042
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the correlations between serum 25-hydroxy vitamin D, interleukin-23 (IL-23), coagulation function indicators, and the severity of rheumatoid arthritis (RA) and treatment effect.Methods:A total of 56 patients with RA who received treatment at Xianyang Central Hospital between February 2019 and January 2023 were included in the RA group, and an additional 56 healthy participants who concurrently underwent physical examination in the same hospital were included in the control group. Serum levels of 25(OH)D, IL-23, and coagulation function indicators were measured in both groups. The severity of RA was evaluated using the Disease Activity Score in 28 Joints (DAS28). The treatment outcomes were assessed based on post-treatment DAS28 scores. Significant differences in serum 25(OH)D, IL-23, and coagulation function indicators were compared among patients with different degrees of disease severity and treatment outcomes. Furthermore, a thorough analysis was conducted to identify risk factors associated with treatment failure in RA patients.Results:The serum 25(OH)D level in the RA group was significantly lower than that in the control group [(21.63 ± 2.29) μg/L vs. (33.06 ± 3.82) μg/L, t = 19.21, P < 0.05]. Prothrombin time (PT), activated partial thromboplastin time (APTT), IL-23, and fibrinogen (FIB) were significantly higher in the RA group [(46.68 ± 5.01) ng/L, (36.85 ± 3.79) seconds, (16.81 ± 1.73) seconds, (5.46 ± 0.58) g/L] compared with the control group ( t = -36.88, -6.19, -11.20, -11.93, all P < 0.05). The serum 25(OH)D levels decreased significantly, with the highest levels observed in the stable group [(30.91 ± 3.12) μg/L], followed by the low activity group [(24.14 ± 2.56) μg/L], the medium activity group [(18.69 ± 1.93) μg/L], and the lowest levels in the high activity group [(15.62 ± 1.63) μg/L, F = 107.90, P < 0.05]. PT, APTT, IL-23 and FIB levels decreased significantly, with the longest periods or highest levels observed in the high activity group [(58.08 ± 6.03) ng/L, (39.92 ± 4.08) seconds, (18.83 ± 2.01) seconds, (6.19 ± 0.63) g/L, F = 72.18, P < 0.05], followed by the medium activity group [(51.25 ± 5.27) ng/L, (37.74 ± 3.91) seconds, (17.15 ± 1.82) seconds, (5.74 ± 0.59) g/L, F = 4.98, P < 0.05], the low activity group [(41.82 ± 4.63) ng/L, (35.41 ± 3.75) seconds, (16.24 ± 1.71) seconds, (5.07 ± 0.54) g/L, F = 14.26, P < 0.05], and the lowest periods or lowest levels in the stable group [(30.67 ± 3.17) ng/L, (33.19 ± 3.42) seconds, (14.29 ± 1.51) seconds, (4.56 ± 0.51) g/L, F = 20.48, P < 0.05]. Serum 25(OH)D level was significantly lower in the treatment failure group than that in the effective treatment group [(18.90 ± 1.97) μg/L vs. (22.63 ± 2.34) μg/L, t = 5.49, P < 0.05]. PT, APTT, IL-23, and FIB in the treatment failure group were significantly higher than those in the effective treatment group [(55.21 ± 5.71) g/L, (40.62 ± 4.17) seconds, (18.56 ± 1.93) seconds, (6.33 ± 0.69) g/L, t = -7.62, -4.48, -4.46, -6.24, all P < 0.05]. IL-23, FIB, PT, and APTT were identified as independent risk factors for treatment failure in RA patients ( OR > 1, P < 0.05), whereas 25(OH)D emerged as a protective factor against treatment failure ( OR < 1, P < 0.05). Conclusion:Significant differences in serum 25(OH)D, IL-23, and coagulation function indicators were observed between RA patients and healthy individuals. These indicators were also closely associated with the severity and treatment outcomes of RA. Therefore, they can be used to assess the disease status and treatment outcomes of RA patients.
