Objective This study examined the relationship of the Sharp score with demographic factors and clinical immune-inflammatory markers in patients with anemia in rheumatoid arthritis (RA). Methods The clinical data of 1057 patients with RA and anemia and 1006 patients with RA without anemia were retrospectively analyzed. Spearman’s correlation coefficient analysis, association rule analysis, and logistic regression were used to study the relationships between the Sharp score and influencing factors in patients with RA and anemia. Results The incidence of anemia was 51.24% (1057/2063), and mild anemia accounted for 81.93% (866/1057) of cases. Spearman’s correlation coefficient and association rule analyses revealed that the Sharp score of patients with RA and anemia was correlated with immune-inflammatory response and anemia. Logistic regression analysis illustrated that advanced age (>60 years), female, low serum iron levels, C-reactive protein positivity, and immunoglobulin A positivity were risk factors for a high Sharp score (>28.25) in patients with RA and anemia. Conclusion The Sharp score is closely related to clinical disease activity and anemia, and it should be considered in the treatment strategy of patients with RA and anemia.

https://journals.sagepub.com/doi/pdf/10.1177/03000605221088560

Factors influencing the Sharp score of 1057 patients with rheumatoid arthritis and anemia: a retrospective study

1,25-dihydroxyvitamin D (1,25(OH)2D) has potent immunomodulatory properties, and many immune cells express the vitamin D receptor (VDR) and the 1α-hydroxylase (1α-OHase) enzyme that synthesizes 1,25(OH)2D from precursor 25-hydroxyvitamin D (25(OH)D). Thus, the immune system is intimately linked to the vitamin D system, and insufficiency of vitamin D may impair both innate and adaptive immune function. Low serum levels of 25(OH)D have been associated with increased risk and severity of autoimmune diseases. This chapter focuses specifically on the relationship between vitamin D and the autoimmune disease rheumatoid arthritis (RA). In addition to describing the mechanisms that link 25(OH)D and 1,25(OH)2D with inflammatory immune responses, this chapter will also document the wide array of studies that have shown association between serum 25(OH)D and RA disease, and the vitamin D supplementation studies that have explored possible beneficial effects of vitamin D supplementation of RA. 

Vitamin D and rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disorder marked by characteristic inflammation of the small joints in addition to diverse systemic manifestations. Vitamin D has immunomodulatory properties, and its deficiency has a significant role in the clinical course of RA. The present research was conducted to study the correlation between serum vitamin D levels and disease activity scores in RA patients.A cross sectional study was carried out on a sample of 50 patients presenting with RA. Disease activity was measured using Modified Disease Activity Score (DAS) criteria. Estimation of serum Vitamin D levels were done using the electrochemiluminescence method and values less than 20 ng/ml were considered as deficiency. Vitamin D levels were then correlated with disease activity scores.The Vitamin D deficiency was observed in 50% of the study population. Rheumatoid arthritis showed female preponderance in this study. Inflammatory markers such as C - reactive protein (CRP) levels and Erythrocyte Sedimentation Rate (ESR) did not differ with RA disease activity. More the number of large joints involved lesser were the vitamin D levels. There was an inverse correlation between Vitamin D levels and RA disease activity.Vitamin D deficiency is significantly correlated with disease severity of RA. This study points to the importance of screening for deficit of vitamin D among RA patients and treat it as early as possible. 

Correlation of Rheumatoid arthritis disease severity with serum vitamin D levels.

Correlation between vitamin D metabolites and rheumatoid arthritis with osteoporosis by ultra-high-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS)

Objectives: In recent years, both the prevalence of obesity and the incidence of RA have been rising. Our aim was to assess the association between overweight or obesity and rheumatoid arthritis (RA). Obesity is arguably the most worrying current public health crisis because it is both extremely common and leads to numerous adverse health outcomes. It is not, therefore, surprising that obesity has important implications for rheumatoid arthritis (RA) and its management. Obesity is an inflammatory state, with excess visceral adiposity being associated with elevation in systemic cytokines, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) . This observation has led to the hypothesis that obesity may drive and contribute to the development and perpetuation of systemic inflammatory conditions including inflammatory arthritis. In support of this concept, there appears to be a strong relationship between metabolic obesity, psoriasis, and psoriatic arthritis, with a significant reduction in the risk of psoriasis among those losing weight after bariatric surgery. A similar study, however, found no reduction in the risk of RA in patients undergoing bariatric surgery. The measurement of inflammatory biomarkers such as ESR and CRP is another objective way to assess disease activity, but these biomarkers may also be subject to bias. We showed that patients with RA who were obese were more likely to have elevated inflammatory markers, similar to what is seen in the general population. The influence of obesity on inflammatory markers has important implications for the interpretability of these measures as a disease activity measure, particularly among obese women 

pdf/the-relationship-between-obesity-and-rheumatoid-arthritis-3i8uynlmwg.pdf

The Relationship between Obesity and Rheumatoid Arthritis

Introduction

Vitamin D is responsible for regulating innate and adaptive immune responses and for boosting the immune system; hence, a decline in its levels results in autoimmunity. Current studies have linked the deficiency of vitamin D to different autoimmune diseases, including rheumatoid arthritis (RA). In this study, we will determine the association between vitamin D level and RA.

Methods

This is a case-control study, conducted in a tertiary care hospital in Pakistan from January 2021 to May 2021. Three hundred patients with a confirmed recent diagnosis of RA were enrolled as the study group. Another 300 participants without RA, matched for age and gender, were enrolled in the study as a control group. RA was diagnosed on the basis of clinical symptoms, radiological features on X-ray, and anti-citrullinated protein levels of more than 20 u/mL.

Results

The mean vitamin D level in participants with RA was significantly lower than in the placebo group (30.18 ± 6.27 vs. 38.29 ± 7.98; p-value: <0.0001). The mean vitamin D level in participants with positive RF patients was significantly lower compared to rheumatoid factor (RF)-negative RA patients (29.21 ± 5.16 vs. 32.26 ± 7.02; p-value: <0.0001). There were more participants with hypovitaminosis D in RF-positive participants as compared to RF negative (88.6% vs. 44.3%; p-value: 0.00001).

Conclusion

There is a high prevalence of vitamin D deficiency in patients with RA and there is a link with disease severity. Therefore, a high index of suspicion is required while evaluating the at-risk patients, especially women, with complaints of vitamin D deficiency. Vitamin D supplementation may be needed for the prevention or avoidance of the progression of the disease.

Association Between Rheumatoid Arthritis and Serum Vitamin D Levels.

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Association Between Rheumatoid Arthritis and Serum Vitamin D Levels.