Vitamin D level and its association with disease activity in Egyptian Rheumatoid arthritis (RA) patients

Rheumatoid arthritis (RA) is a chronic inflammatory disease that affects about 1% of the human population. Its incidence increases between 25 and 55 years and is the most common type of chronic inflammatory arthritis . It affects joints bilaterally with synovial hyperplasia, cartilage erosion, bone destruction, and progressive loss of function . also characterized by systemic features and joint involvement. It can lead to significant morbidity and mortality so early diagnosis and proper treatment are crucial in decreasing the burden of this disease . According to the World Health Organization mortality database of 31 countries, RA accounts for almost 18% of all deaths caused by different types of arthritis and other musculoskeletal diseases, but the exact cause of RA remains unknown

Inclusion Criteria:

• Both males and females in the age group of 1875 years having RA according to the American College of Rheumatology European League Against Rheumatism 2010 criteria (Meena et al., 2018). Will enrolled in this study

Exclusion Criteria:

• Patients with malnutrition, hepatic and renal dysfunction, hyperparathyroidism, hyperthyroidism, diabetes mellitus, and patients on Vitamin D supplementation in the past 6 months or on medications that can affect bone and Vitamin D metabolism (anticonvulsants, diuretics, and thyroxin) were excluded from this study.
• Patients with overlap syndrome
• known allergy to DMARDs, 1,25 dihydroxy vitamin D3 or calcium supplements

Egyptions

Sample size was calculated using Epi- Info7. Based on previous study the prevalence of vitamin D insufficiency and deficiency in RA patients was 56% (Cesshetti 2016. ). With a confidence limits of 8% and a confidence level of 80% the minimum number of patients required for this study is 65 patients RA and 65 of healthy