Investigation of clinical and laboratory manifestations of rheumatoid arthritis depending on the level of serum fetuin-A
Aim of the study. To study the association between the serum FA in patients with RA and separate clinical and laboratory manifestations of the disease. Material and methods. A total of 140 subjects were enrolled in the study. Among them, 110 were RA patients and 30 were conventionally healthy subjects. The level of serum FA was measured in both groups. All patients underwent complete clinical and laboratory examination and X-ray imaging of the impaired joints. Results. The level of normal FA in healthy subjects calculated as M±2a totalled 653.55-972.19|ig/ml. The mean level of FA in RA patients was 765.67±120.67|ig/ ml, which is statistically lower than that in the donors: 812.95±76.21|ig/ml (t=-2.03; p=0.0437). The mean FA level in conventionally healthy patients was statistically higher than the same index in RA-factor positive patients with cyclic citrullinated peptide antibodies, moderate and high activity, late clinical stage, X-ray stages III and IV, functional classes II, III and IV, joint erosion, abarticular manifestations and the presence of complicating diseases. Intra-group analysis (odds ratio and adjusted odd ratio) showed the patients with lower FA level (below 653.55|ig/ml) to have a 14-fold higher possibility of CCP antibodies positivity (6-fold after adjustment), 1.86-fold higher disease activity (2.39-fold after adjustment), 6.6-fold higher probability of X-ray stage IV (with no statistical significance after adjustment) and 29-fold higher chance of presence of complications (46-fold after adjustment). Conclusion. According to the data obtained in our study, lowering of the serum FA level is characteristic to RA patients. The hepatokine concentration below 653.55|ig/ml may suggest 2.39-fold higher chance of higher disease activity and 46-fold higher probability of complicated RA progression.