Abstract
Determine vitamin D receptor gene BsmI, FokI polymorphism and 25-hydroxyvitamin D in early Egyptian rheumatoid patients and its association to subclinical atherosclerosis. This study included forty early rheumatoid arthritis patients and forty healthy controls. Disease activity score 28 (DAS-28), Modified Health Assessment Questionnaire (MHAQ), Carotid intima-media thickness (cIMT) were assessed using B-mode ultrasound, Erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Lipid profile, anti cyclic citrullinated PolyPeptid (anti-CCP), serum interleukin-6, Total serum vitamin D and genotype determination of BsmI, FokI polymorphism and allel frequency were measured. Vitamin D deficiency was observed in 25% of patients. There was no significant difference between RA patients and controls regarding the distribution of BsmI genotype frequencies and allele. However, a significant difference between rheumatoid arthritis patients and controls regarding the distribution of FokI genotype and allele frequencies was found. In addition, FokI polymorphism and the F allele was significantly associated with RA. anti-CCP, interleukin-6 levels, (cIMT) and vitamin D deficiency were significantly higher in the presence of bb homozygote of BsmI genotypes and FF homozygote of FokI genotypes. A significant negative correlation between 25 hydroxy vitamin D levels with (DAS-28), ESR, (CRP), and IL-6 (P < 0.001). However, there was positive correlation between 25 hydroxyvitamin D levels and HDL-C (P < 0.001).
Highlights
Rheumatoid arthritis (RA) is an autoimmune disease that causes systemic inflammatory disorder and affects many tissues and organs, mainly the synovial joints [1].People with RA are susceptible to cardiovascular disease (CVD), which is the cause of 40–50% of the deaths in this population [2].The patients with subclinical CVD have a higher risk for atherosclerotic plaques, increased intima-media thickness (IMT) of the carotid arteries [3].The vitamin D receptor (VDR) gene is located on chromosome 12q12–q14 in humans, and four adjacent restriction fragment length polymorphisms for BsmI,ApaI,FokI,and TaqI at the 3¢ end of VDR have been previously identified
Patients with early RA exhibited mild dyslipidemia characterized by significantly higher baseline of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) compared with controls
The atherogenic ratio of total cholesterol/high-density lipoprotein (HDL)-C, as well as that of LDL-C/high-density lipoprotein cholesterol (HDL-C), was significantly higher in RA patients compared with controls
Summary
People with RA are susceptible to cardiovascular disease (CVD), which is the cause of 40–50% of the deaths in this population [2]. The VDR gene is located on chromosome 12q12–q14 in humans, and four adjacent restriction fragment length polymorphisms for BsmI,ApaI,FokI,and TaqI at the 3¢ end of VDR have been previously identified. Their associations with vitamin D levels and several diseases have been investigated [6,7]. In this study, we determined VDR gene BsmI, FokI polymorphism and 25-hydroxyvitamin D in Egyptian patients with early RA and its association with cardiovascular risk in such population
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