AB0323 Relationshib between serum levels of leptin & homocystein in rheumatoid arthritis patients with or without extra articular manifestations
Authors: Y. Hussein Gazar
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> <b>Rheumatoid arthritis</b> (RA) is a chronic, systemic disorder with unknown etiology, which is characterised by involvement of hand joints and deformation. Rheumatoid arthritis is characterised by synovial inflammation and hyperplasia. chronic inflammatory process of the joints that progresses through different stages of increasing severity characterises rheumatoid arthritis. <h3>Objectives</h3> In this study we aimed to determine the relationship and correlation between serum homocystein and leptin levels in {patients with rheumatoid arthritis (RA) without extra articular manifestation (non Ex RA)(GROUP-A) and RA patients with extra articular manifestation (ExRA) (GROUP B) and disease progression. <h3>Methods</h3> 80 patients diagnosed as rheumatoid arthritis (according TO ACR/EULAR 2010 classification criteria) (according TO ACR/EULAR 2010 classification criteria) and selected as follow: (Group A) 40 patients without extra articular manifestation (nonExRA) and (Group B) 40 patients with variable extra articular manifestation (ExRA)), CONTROL GROUP (C) Another 40 apparently healthy persons as controls. RA patients were divided into three groups based on Disease Activity Scores in 28 joints (DAS28) as low disease activity, moderate disease activity, and high disease activity groups. Of the patients (non Ex RA), 11 (27.5%) had low disease activity (DAS28=2.6–3.2), 15 (37.5%) had moderate disease activity (DAS28=3.2–5.1), and 14 (35.0%) had high disease activity (DAS28 ≥5.1). Laboratory investigations were performed for all patients, including determination of haemoglobin concentration (Hb), erythrocyte sedimentation rate (ESR), and C-reactive protein. Serum concentrations of tumour necrosis factor-alpha (TNF-α), IL-6, Homocystein and Leptin were measured. <h3>Results</h3> Significant differences were found between RA patients (group A+group B) and controls healthy group (group C) with regard to the mean levels of Hb, ESR, TNF-α and IL-6 (p&lt;0.05). As regards to serum leptin, non significant level differences between healthy control group (20.43±8.73 ng/ml) and patient groups (group II and III) (22.43±7.73 ng/ml). while A statistically significant higher mean level serum Homocystein concentration (p&lt;0.05) was found in patients (group A and B) (11.79+8.72 μmol/L) than in control (group C) (8.8+1.58 μmol/L). Significant differences were found between non ExRA (group A) and ExRA (group B) with regard to the mean levels of Hb, ESR, TNF-α and IL-6 (p&lt;0.05). A statistically non significant differences in mean level of serum Leptin concentration (p&gt;0.05) was found in group A (22.43±5.73 ng/ml) than in group B (24.43±5.73 ng/ml). While a significant mean level of serum Homocystein concentration (P value&lt;0.05) was found in Group B patients (19.43±1.08 μmol/L) than in group A (11.79±13.05 μmol/L) (p&lt;0.05). Positive significant correlations were detected between serum Homocystein and ESR, TNF-α, IL-6, and DAS-28 (p&lt;0.05) in group B Multiple linear regression analysis showed that DAS- 28 and ESR were the main variables associated with serum Homocystein in RA patients (p&lt;0.05). <h3>Conclusions</h3> Serum leptin can't be considered of value as an inflammation marker in monitoring RA patients. Seum homocystein can be used as a marker for probability of extra articular complication of RA. <h3>Disclosure of Interest</h3> None declared