Evaluation of paraoxonase and arylesterase activities in Egyptian patients with ankylosing spondylitis.

The role of paraoxonase (PON) and arylesterase (ARE) in the pathogenesis of inflammatory arthritis has been investigated, and their serum levels have been evaluated, but clinical study concerning PON1 and ARE and ankylosing spondylitis (AS) is little reported in literature. The aim of this study was to investigate PON1 and ARE activities in AS in comparison with healthy persons and their relation with the disease activity parameters. 35 AS patients and 35 healthy controls (matched for age and sex) participated. Disease activity of AS patients was assessed clinically according to the Bath AS disease activity index, and AS functional impairment was assessed using the Bath AS Functional Index. Serum samples were collected from all subjects to evaluate serum PON1, ARE activities, and lipid profile. The mean serum triglycerides, total cholesterol, and low density lipoprotein (LDL) were significantly higher in the AS patients than in controls, while the high-density lipoprotein (HDL) is significantly lower in the AS patients than controls. Serum PON1 and ARE activities were significantly lower in AS patients than in controls, while malondialdehyde (MDA) was significantly higher. AS patients with active disease had significantly higher serum triglycerides, total cholesterol, LDL and MDA while lower HDL, PON1 and ARE than those with no active AS. Decrease in the PON1/ARE activity leading to generation of oxidative stress may play an important role in the pathogenesis of AS. Moreover, it seems that activity of PON1/ARE in patients with AS is strictly correlated with the activity of the inflammatory process.

Serum vitamin D level and bone mineral density in premenopausal Egyptian women with fibromyalgia.

Patients with fibromyalgia syndrome (FMS) have impaired mobility and therefore get less sunlight exposure, we postulated that they may be at increased risk of developing osteoporosis (OP). The aim of this study was to assess and compare serum vitamin D level and bone mineral density (BMD) value in patients with primary FMS (PFMS) and healthy controls. A total of 50 patients with PFMS participated in this case-control study, and 50 healthy females who were age-matched to the patients were used as the control group. Venous blood samples collected from all subjects were used to evaluate serum 25-hydroxyvitamin D3 (25-OHD). BMD was measured at the lumbar spine (L2-L4) anteroposterior, femoral neck and forearm by dual-energy X-ray absorptiometry. Patients with PFMS had significantly lower serum 25-OHD than controls (15.1 ± 6.1 and 18.8 ± 5.4 ng/ml, respectively, p = 0.0018). Apart from the BMD in the lumbar spine, which was significantly lower in the PFMS patients compared with controls (p = 0.0012), no significant difference was found in other measures of BMD. Compared to PFMS patients who had serum level of the 25-OHD >20 ng/ml, the patients with 25-OHD ≤20 ng/ml are more likely to have impaired short memory (46.4 vs. 13.6%, respectively, p = 0.0136), confusion (50 vs. 18.2%, respectively, p = 0.0199), mood disturbance (60.7 vs. 27.3%, respectively, p = 0.0185), sleep disturbance (53.6 vs. 22.7%, respectively, p = 0.0271), restless leg syndrome (57.1 vs. 27.3%, respectively, p = 0.0346) and palpitation (67.9 vs. 36.4%, respectively, p = 0.0265). Serum level of the 25-OHD is inversely correlated with visual analogue scale (VAS) of pain (p = 0.016), Beck score for depression (p = 0.020) and BMD at lumbar spine (p = 0.012). The lumbar BMD inversely correlated with VAS of pain (p = 0.013) and Beck score for depression (p = 0.016). This study confirmed high prevalence of hypovitaminosis D among in patients with PFMS. This study confirmed the concept that FMS is a risk factor for OP. Based on this, an early nutrition program rich in calcium and vitamin D, appropriate exercise protocols, and medical treatment should be considered in these patients in terms of preventing OP development.