Oxidative Stress, Antioxidant Status and Calcium, Phosphorous Levels In Rheumatoid Arthritis- A Case Control Study

Abstract

Background and Objectives: ABSTRACT Rheumatoid Arthritis( RA ) is a chronic multisystem disease of unknown cause. RA affects approximately 1-2% of the total population. The characteristic feature of RA is non-specific inflammation of the peripheral joints with joint swelling, morning stiffness, destruction of articular tissues and joint deformities. Formation of reactive oxygen species and lipid peroxides as a result of disease activity may play an important role in RA. Oxidative stress and decreased antioxidant status are the hallmarks in patients of Rheumatoid Arthritis as observed in recent years. The objectives of the study was to compare lipid peroxidation, antioxidant status and evaluate calcium, phosphorous levels in patients of Rheumatoid Arthritis and controls. Methods: The present study comprises of 40 cases of RA clinically diagnosed and confirmed by laboratory tests attending the OPD of KLE Society's Dr Prabhakar Kore Hospital and Research Centre, Belgaum. This study was undertaken between September 2007 to August 2008. All the patients were in the age group of 40-60 years including both the sexes. Biochemical parameters like malondialdehyde, enzymatic antioxidants : superoxide dismutase, glutathione reductase and non enzymatic antioxidants like vitamin A vitamin E, vitamin C were estimated in cases and controls. Calcium and phosphorous levels were also measured in healthy controls and the cases. xiii Results: The mean level of blood malondialdehyde ( in nmol/ml ) in controls was 6.19 ± 0.96 and 11.48 ± 0.76 in cases. The mean level of superoxide dismutase ( IU/g of Hb) in controls was 948.32 ± 99.88 and 443.68 ± 111.69 in the cases. The mean glutathione reductase level ( in IU/g of Hb ) in controls was 8.91 ± 1.04 and 2.96 ± 0.79 in the cases. The mean level of vitamin A ( in μg/dl ) in controls was 35.13 ± 5.25 and 11.60 ± 3.03 in the cases. The mean level of vitamin E ( in mg/dl ) in controls was 0.92 ± 0.10 and 0.53 ± 0.14 in the cases. The mean vitamin C level ( in mg/dl ) in controls was 0.88 ± 0.12 and 0.48 ± 0.09 in the cases. The mean value of Calcium ( in mg/dl ) in controls was 10.21 ± 0.65 and 7.33 ± 0.93 in the cases. The mean value of phosphorous ( in mg/dl ) in controls was 2.89 ± 0.57 and 4.28 ± 0.81 in the cases. Interpretation and conclusion: Our study revealed that there was increased oxidative stress and decreased antioxidant defense in patients of Rheumatoid Arthritis. Our study also revealed that there was altered serum calcium and phosphorous levels in patients of Rheumatoid Arthritis.. Supplementation of natural antioxidants to the individuals who are diagnosed as Rheumatoid Arthritis may alleviate the morbidity associated with Rheumatoid Arthritis to a certain extent.