Vitamin D receptor gene polymorphism as possible risk factor in rheumatoid arthritis and rheumatoid related osteoporosis.

OBJECTIVE: To study the role of VDR polymorphisms as risk factor for RA and osteoporosis, and whether osteoporosis complicating RA is due to RA or VDR polymorphisms. METHODS: VDR gene polymorphisms ApaI, TaqI, BsmI and FokI were typed by RFLP for 128 RA patients, 30 postmenopausal osteoporotic females and 150 healthy controls. RESULTS: Significant differences were found between patients and healthy controls in the frequency of BsmI and TaqI (Pc<0.05) but no significant associations were found for FokI and ApaI polymorphisms except for aa genotype (Pc<0.001). Titers of RF were higher with aa and bb genotypes. Anti-CCP and CRP levels were higher with aa genotype and more bone loss was associated with Bb genotype. Ff genotype frequency was higher in RA patients with osteoporosis than those without osteoporosis. CONCLUSIONS: The ApaI, BsmI and TaqI polymorphisms may be a susceptibility risk factors for RA and the Ff genotype may be responsible for development of osteoporosis in RA Egyptian patients. However, the present study needs to be replicated in a large number of patients from allover the Egypt and also in multi-ethnic populations.

Serum leptin in Egyptian patients with fibromyalgia syndrome: relation to disease severity.

AIM: Recently, a large body of studies has focused on the leptin levels in psychiatric disorders. This study aimed to measure serum leptin levels in fibromyalgia syndrome (FMS) due to a significantly higher prevalence of psychiatric disorder and to determine the relationship between leptin and FMS. METHODS: The present study was a cross-sectional descriptive study. Fifty FMS female patients and 50 healthy females serving as a control group were included. Serum samples tested for serum leptin levels were determined by a specific enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum leptin levels were significantly lower in FMS patients compared to the control group. The mean serum leptin in patients with FMS was 7.1 ± 6.8 ng/mL compared to 9.4 ± 4.5 ng/mL in the controls (mean difference, -2.48, 95% CI: -4.78, -0.18, P = 0.035). Serum leptin level is inversely correlated with visual analogue scale (VAS) of pain (P = 0.016), VAS of fatigue (P = 0.002), VAS of global severity (P = 0.011), VAS of anxiety (P = 0.027), global self-rating index (P = 0.020), Health Assessment Questionnaire score (P = 0.016), fibromyalgia impact questionnaire (FIQ) (P = 0.025), Beck Depression Inventory (P = 0.002), tender points (TPs) count (P = 0.041), TPs score (P = 0.015), and Pittsburg Sleep Quality Index (P = 0.006). Mean serum leptin levels were also significantly lower in FMS patients with post-exertion pain (P = 0.010), depression (P = 0.029), mood disturbance (P = 0.018), anxiety (P = 0.030), short memory difficulties (P = 0.017), sleep disturbance (P = 0.028), restless leg syndrome (P = 0.016), temperomandibular joint syndrome affection (P = 0.043), palpitation (P = 0.022), and irritable bowel syndrome (P = 0.028) than those without. CONCLUSION: We found a significant decrease in serum leptin in FMS patients compared to controls and this decrease correlated with disease severity.