Rheumatoid arthritis (RA) is associated with metabolic and nutritional disturbances. Vitamin D3 and vitamin K2 are essential factors for bone health. To assess the relationship between vitamin D3 and K2 with dual energy X-ray absorptiometry (DEXA) in patients with active RA. The study included 30 active RA patients. Key biochemical markers related to bone metabolism, vitamin D3 and K2, DEXA and disease activity score (DAS28) were studied. Total Sharp score (erosions) was assessed. The cases were 24 females and 6 males (F:M 4:1), with a mean age of 45.2 ± 10.9 years (23–64 years) and age at onset 38 ± 9.5 years. The mean DAS28 was 4.8 ± 1.2 (2.71–7). The mean vitamin D3 was 23.7 ± 10.6 ng/ml (9.2–43.7), vitamin K2 3.04 ± 1.1 ng/ml (1.5–4.2), ionized calcium 3.6 ± 0.48 (2.8–4.4), DEXA (t score) −1.12 ± 0.67 (−2.4–0) and Total Sharp score (erosions) 11.8 ± 13.9 (1–47). In patients there was a significant decrease in vitamin D3 compared to the control (23.7 ± 10.6 vs. 46.9 ± 7.1 ng/mL respectively , p < 0.0001) and vitamin K2 (3.04 ± 1.08 vs . 5.1 ± 0.7 ng/mL respectively , p < 0.0001). There was osteopenia in cases vs. controls (−1.12 ± 0.67 vs . −0.81 ± 0.11 respectively , p < 0.01). Ionized calcium levels were significantly elevated in cases (3.6 ± 0.48 vs . 3.02 ± 0.58 mg/dL respectively, p < 0.0001). Radiographic assessments showed progressive joint damage. Reduced vitamin D3 and K2 as well as bone mineral density is established in RA patients. Vitamin D3 and K2 supplementation, lifestyle modifications and metabolic monitoring may alleviate bone loss and improve disease outcomes.
El‐Essawi et al. (Thu,) studied this question.