danДоклады Национальной академии наук БеларусиDoklady of the National Academy of Sciences of Belarus1561-83232524-2431The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1561-8323-2020-64-6-723-729dan-933Research ArticleМЕДИЦИНАMEDICINEЧастота встречаемости гиповитаминоза D и ассоциации плазменной концентрации 25(OH)D с показателями активности заболевания у пациентов с ревматоидным артритомRate of hypovitaminosis D and association of plasma concentration of 25(OH)D with indicators of disease activity in patients with rheumatoid arthritisРуденкоЕ. В.RudenkoA. V.

Руденко Елена Викторовна – канд. мед. наук, доцент

ул. П. Бровки, 3, 220013, Минск

Rudenko Alena V. – Ph. D. (Medicine), Associate professor

3, P. Brovka Str., 220013, Minsk

alenka.v.ru@gmail.comТябутТ. Д.TyabutT. D.

Тябут Тамара Дмитриевна – д-р мед. наук, профессор

ул. П. Бровки, 3, 220013, Минск

Tyabut Tamara D. – D. Sc. (Medicine), Professor

3, P. Brovka Str., 220013, Minsk

tamara_dt@mail.ruБугловаА. Е.BuglovaA. E.

Буглова Анна Евгеньевна – канд. мед. наук, доцент

ул. П. Бровки, 3, 220013, Минск

Buglova Anna E. – Ph. D. (Medicine), Associate professor

3, P. Brovka Str., 220013, Minsk

anna_buglova@mail.ruБабакГ. А.BabakG. A.

Бабак Галина Алексеевна – канд. мед. наук, заведующий отделением

пр. Независимости, 64, 220013, Минск

Babak Galina A. – Ph. D. (Medicine), Head of the Department

64, Nezavisimosti Ave., 220013, Minsk

babakgalina@mail.ruМорозикП. М.MorozikP. M.

Морозик Павел Михайлович – канд. биол. наук, доцент, заведующий лабораторией

ул. Академическая, 27, 220072, Минск

Morozik Pavel M. – Ph. D. (Biology), Associate professor, Head of the Laboratory

27, Akademicheskaya Str., 220072, Minsk,

P.Marozik@igc.byБорисенкоТ. Д.BorisenkoT. D.

Борисенко Татьяна Дмитриевна – канд. мед. наук, доцент, заведующий лабораторией

пр. Независимости, 64, 220013, Минск

Borisenko Tatiana D. – Ph. D. (Medicine), Head of the Laboratory

64, Nezavisimosti Ave., 220013, Minsk

tatyanadm77@mail.ruБелорусская медицинская академия последипломного образованияBelarusian Medical Academy of Postgraduate EducationПервая городская клиническая больницаFirst City Clinical HospitalИнститут генетики и цитологии Национальной академии наук БеларусиInstitute of Genetics and Cytology of the National Academy of Sciences of Belarus202031122020646723–729Copyright © Руденко Е.В., Тябут Т.Д., Буглова А.Е., Бабак Г.А., Морозик П.М., Борисенко Т.Д., 20202020Руденко Е.В., Тябут Т.Д., Буглова А.Е., Бабак Г.А., Морозик П.М., Борисенко Т.Д.Rudenko A.V., Tyabut T.D., Buglova A.E., Babak G.A., Morozik P.M., Borisenko T.D.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://doklady.belnauka.by/jour/article/view/933

Гиповитаминоз D – важный экологический фактор риска, влияющий на распространенность и тяжесть некоторых аутоиммунных заболеваний, включая ревматоидный артрит (РА). Цель настоящего исследования – выявить частоту встречаемости дефицита и недостаточности витамина D у пациентов с РА, установить ассоциации плазменной концентрации 25(ОН)D с показателями активности заболевания. В исследование включены 156 пациентов с РА, средний возраст 60,2 ± 13,9 лет. Пациентам проводилась оценка клинической картины заболевания, выполнялось определение уровня ревматоидного фактора (РФ), С-реактивного белка (СРБ), содержание общего витамина D (25(OH)D), антител к циклическому цитруллинированному пептиду (АЦЦП). Активности РА оценивались с применением расчетных индексов DAS28 (Disease Activity Score), SDAI (Simplified Disease Activity Index) и CDAI (Clinical Disease Activity Index). Средние уровни 25(OH)D в обследованной выборке составили 25,2 ± 13,2 нг/мл. Нормальные показатели витамина D, его недостаточность и дефицит наблюдались у 47 (30,3 %), 45 (28,7 %) и 64 (40,7 %) пациентов соответственно. Результаты проведенного исследования свидетельствуют о высокой распространенности гиповитаминоза D у пациентов с РА. Низкий уровень 25(OH)D у пациентов с РА ассоциируется с более высокими показателями активности заболевания по индексам DAS28, SDAI и СDAI и большим количеством болезненных суставов. Назначение витамина D целесообразно использовать в качестве дополнительной терапии у пациентов с активным РА с потенциальной иммуномодулирующей целью, а также для профилактики и лечения нарушений костного метаболизма.

Vitamin D deficiency is an important environmental risk factor that influences the prevalence and severity of several autoimmune diseases, including rheumatoid arthritis (RA). The aim of this study was to determine the incidence of vitamin D insufficiency and deficiency in patients with RA, to establish the relationship between serum vitamin D levels and indicators of disease activity. 156 patients with RA were included in the study, mean age 60.2 ± 13.9 years. Assessment of clinical status was performed, serum concentrations of rheumatoid factor (RF), C-reactive protein (CRP), total vitamin D (25(OH)D), antibodies to cyclic citrullinated peptide (ACCP) were determined. RA disease activity was evaluated using DAS28 (disease activity score), SDAI (Simplified Disease Activity Index) и CDAI (Clinical Disease Activity Index) scores. Average levels of 25(OH)D in the surveyed sample were 25.2 ± 13.2 ng/ml. The results of the study indicate a high prevalence of vitamin D deficiency in patients with RA. Normal indicators of vitamin D, its insufficiency and deficiency were observed in 47 (30.3 %), 45 (28.7 %) and 64 (40.7 %) patients, respectively. Low level of serum 25(OH)D was associated with higher indices of RA activity according to DAS28, SDAI and CDAI, as well as with greater tender joint count. Vitamin D should be prescribed as an adjunctive therapy in patients with active RA due to its potential immunomodulatory effect, as well as for the prevention and treatment of bone metabolism disorders.

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The authors declare that there are no conflicts of interest present.