血清25-羟维生素D载脂蛋白A1与类风湿关节炎患者病理特征关系研究OA

Objective:To investigate the relationship between serum 25-hydroxyvitamin D[25(OH)D],apolipoprotein A1(ApoA1),inflammation,bone metabolism indicators,and concurrent osteoporosis(OP)in patients with rheumatoid arthritis(RA).Methods:From January 2022 to March 2024,164 RA patients ad-mitted to our hospital were selected as the RA group,and 120 healthy controls who came for physical examina-tion at the same time were selected as the control group.Serum levels of 25(OH)D,ApoA1,inflammatory fac-tors(IL-8,TNF-α,IL-17),and bone metabolism markers(β-CTX,B-ALP,PINP)were detected by en-zyme-linked immunosorbent assay.The Pearson test was used to analyze the correlations of serum 25(OH)D and ApoA1 with indicators of inflammation and bone metabolism.The occurrence of osteoporosis in RA patients at admission was statistically analyzed.The clinical data and serum 25(OH)D and ApoA1 levels of the non-osteoporosis group and the osteoporosis group were compared.A logistic regression model was used to analyze the influencing factors of osteoporosis in RA patients.Results:Compared with the control group,the serum lev-els of ApoA1,interleukin-17(IL-17),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α),and type I collagen carboxy-terminal peptide β-specific sequence(β-CTX)in the RA group were significantly in-creased(P<0.05),while the serum levels of 25(OH)D,bone alkaline phosphatase(B-ALP),and type I procollagen amino-terminal propeptide(PINP)were significantly decreased(P<0.05).Correlation analysis indicated that serum ApoA1 was positively correlated with IL-8,TNF-α,IL-17,and β-CTX(r=0.502,0.456,0.489,0.511,P<0.05),and negatively correlated with B-ALP and PINP(r=-0.440,-0.476,P<0.05);serum 25(OH)D was negatively correlated with IL-8,TNF-α,IL-17,and β-CTX(r=-0.436,-0.477,-0.526,-0.483,P<0.05),and positively correlated with B-ALP and PINP(r=0.514,0.455,P<0.05).Among 164 RA patients,65 cases(39.63%)had osteoporosis.Compared with the non-osteoporosis group,age,RA duration and ApoA1 in the osteoporosis group were significantly increased(P<0.05),25(OH)D was significantly decreased(P<0.05).There were no statistically significant differences in the duration of glucocorticoid use,gender,smoking history,drinking history,fracture history,and disease activity(P>0.05).Multivariate Logistic regression analysis showed that older age,longer RA duration,low 25(OH)D,and high ApoA1 were risk factors for poor osteoporosis in RA patients(P<0.05).Conclusion:Low serum 25(OH)D levels and high ApoA1 levels are associated with abnormally elevated inflammatory factors,bone metabolism disorders and the development of osteoporosis in patients with RA;they can possibly be used as potential markers for assessing osteoporosis associated with RA.