Oxidative Stress and Vitamin D Deficiency in Active Rheumatoid Patients

Rheumatoid arthritis (RA) is a chronic inflammatory multisystem disease of unknown cause characterizing patients with increased reactive oxygen species (ROS), lipid peroxides, and low antioxidants status. It has been claimed that vitamin D in its physiological active form exert an immune regulatory activities. We aimed to assess the level of vitamin D [25(OH) D3] in active RA patients compared to normal controls, it's correlation with disease activity parameters, biochemical parameters and antioxidants levels. Fifty patients with active RA and 30 healthy controls matched for age and gender were included into the present study. Serum [25(OH) D3] is measured as it is the precursor of active vitamin D [1, 25(OH) 2D3] which has a very short half live by Radio immune assay. Oxidative stress was assessed by measuring serum malondialdehyde (MDA) and enzymatic antioxidant status by estimating superoxide dismutase (SOD) and glutathione peroxidase (GPX). The serum levels of 25(OH) D3, SOD, and GPX were significantly lower in RA patients when compared to their level in the control group (p< 0.001). On the other hand, level of MDA was significantly higher in the RA patients than that of in the healthy control subjects (p< 0.001). We found highly statistical negative correlation between 25(OH) D3andMDA levels (P < 0.001and r = -0.787). On the other hand, SOD and GPX positively correlated with 25(OH) D3 levels (P < 0.001 and P<0.006 respectively and r = 0.507 and0.383 respectively). We found a statistical significant negative correlation between 25(OH) D3 and Disease Activity Score-28(DAS-28) and Erythrocyte sedimentation rate (ESR) levels (p=0.010 & 0.006 respectively and r was-0.363&-0.382 respectively. From the results of this study it could be suggested that low 25(OH) D3and disturbed anti-oxidant levels are prevalent in the Egyptian RA patient. Data of the present study showed a clear association between the level of 25(OH) D3and different signs of disease activity as well as the level of antioxidants consequently, a routine 25(OH) D3 and antioxidant supplementations to RA patients is recommended for better prognosis.