HOMOCYSTEINE LEVEL STATUS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN DUHOK: IN RELATION TO DISEASE. ACTIVITY SCORE
Keywords:
RA, Hcys, ACCP, CRP, DAS28-CRP
Abstract
Rheumatoid arthritis (RA) causes high rate of the mortality. Cardiovascular disease (CVD) is markedly elevated in RA partly due to accelerated atherosclerosis (AS) from chronic inflammation. Homocysteine’ elevation (Hcys) strongly related to the AS and CVD’s progression in RA. Current study aims to evaluates Hcys level status and its relation with disease activity (DA) and inflammation marker (CRP) in Duhok RA patients.
Sixty-four RA patients (case) were involved in this study with equal number of healthy individuals (control), means± SD of their age were 47.78 ± 14.08 and 46.98 ± 15 respectively. ratio of females to males was (8.1 and 7.0) in case and control respectively. Blood was analyzed and RA related laboratory and biochemical markers were investigated.
The results revealed that Means±SD of Hcys was higher in case comparing to control (17.30±8.52 and 7.2±3.4) respectively. RA patient with high DA score recorded higher percentage intra group of increased Hcys level (52%).
This study concludes that there is a strong association between Hcys level and RA activity, severity and inflammation process in RA Duhok patients. Hcys could play role as a predictor marker helping physicians for good monitoring and managing RA disease
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References
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Prevoo ML, van’t Hof MA, Kuper HH et al. (1995), Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 38: 44–48
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Selhub J. (2006), The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J Nutr. 2006; 136(6): 1726-1730.
Slot O. (2013), Homocysteine, a marker of cardiovascular dis- ease risk, is markedly elevated in patients with gout. Ann Rheum Dis. 72(3): 457.
Szekanecz Z, Kerekes G, Der H, Sandor Z et al. (2007), Accelerated atherosclerosis in rheumatoid arthritis. Ann N Y Acad Sci. 2007; 1108: 349-358. 19.
Van den Hoek J, Boshuizen HC, Roorda LD, Tijhuis GJ, Nurmohamed MT, van den Bos GAM, et al. (2017), Mortality in patients with rheumatoid arthritis: a 15-year prospective cohort study. Rheumatol Int.;37(4):487–93.
Van Ede AE, Laan RF, Blom HJ, Boers GH et al. (2002), Homo- cysteine and folate status in methotrexate-treated patients with rheumatoid arthritis. Rheumatology.; 41(6): 658-665.
Vasiljevic D, Tomic-Lucic A, Zivanovic S, et al. (2015), Plasma homocysteine concentrations in patients with Rheumatoid arthritis. Serbian Journal of Experimental and Clinical Resear
Abd El-Aziz TA, Mohamed RH. (2017), Influence of MTHFR C677T gene polymorphism in the development of cardiovascular disease in Egyptian patients with rheumatoid arthritis. Gene. 610:127–132. doi: 10.1016/j.gene.2017.02.015. [PubMed] [Cross Ref] [Google Scholar]
Kerola AM, Rollefstad S, and Semb A G, (2021), Atherosclerotic Cardiovascular Disease in Rheumatoid Arthritis: Impact of Inflammation and Antirheumatic Treatment, Eur Cardiol. 2021 Feb; 16: e18. doi: 10.15420/ecr.2020.44, PMCID: PMC8145075.
Baskan BM, Sivas F, Aktekin LA, Dogan YP, Ozoran K, Bo- dur H. (2009), Serum homocysteine level in patients with ankylos- ing spondylitis. Rheumatol Int. 29(12): 1435-1439.
Liu Bo, Zhihao C, Xiaoqi D, and Guangming Q, (2018), Association of prehypertension and hyperhomocysteinemia with subclinical atherosclerosis in asymptomatic Chinese: a cross-sectional study, BMJ Open. 2018; 8(3): e019829, 10.1136/ bmjopen-2017-019829, PMC5875630, PMID: 29555791
Borman P, Taşbaş O, Karabulut H, Tukun A, Yorgancıoğlu R. (2014), Thymidylate synthase genetic poly- morphism and plasma total homocysteine level in a group of Turkish patients with rheumatoid arthritis: relationship with disease activity and methotrexate toxicity. Rev Bras Reumatol. 2015. pii: S0482- 5004(15)00017-0. doi: 10.1016/j.rbr.12.001.
Caramaschi P, Martinelli N, Biasi D, Carletto A, Faccini G, Volpe A, et al. (2003), Homocysteine plasma concentration is related to severity of lung impairment in scleroderma. J Rheumatol. 30(2): 298-304.
Choi ST, Kim JS, Song JS. (2014), Elevated serum homocysteine levels were not correlated with serum uric acid lev- els, but with decreased renal function in gouty patients. Korean Med Sci. 29(6): 788-792.
Crowson CS, Rollefstad S, Ikdahl E et al. (2018), Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis. Ann Rheum Dis. 2018; 77:48–54. doi: 10.1136/annrheumdis-2017-211735. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Aletaha D., Neogi T., Silman A.J., Funovits J., Felson D.T., Bingham C.O., et al., (2010), Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative, Ann. Rheum. Dis. 69 (9),1580–1588
Galiutina OIu, Bychak OV. (2011), Relationship of silent myocardial ischemia with the course of rheumatoid arthritis and hyperhomocysteinemia. Lik Sprava. 2011; (1-2): 48-52
Gonzalez-Gay MA, Gonzalez-Juanatey C, Lopez-Diaz MJ, et al. (2007), HLA-DRB1 and persistent chronic inflammation contribute to cardiovascular events and cardiovascular mortality in patients with rheumatoid arthritis. Arthritis Rheum.; 57(1): 125-132.
Gonzalez-Gay MA, Gonzalez-Juanatey C, Pineiro A, Garcia-Porrua C, Testa A, Llorca J. (2005), High-grade Cre- active protein elevation correlates with accelerated atherogenesis in patients with rheumatoid arthritis. J Rheumatology. 32(7): 1219–1223.
Goodson NJ, Symmons DP, Scott DG, Bunn D, Lunt M, Silman AJ. (2005), Base line levels of C-reactive protein and prediction of death from cardiovascular disease in patients with inflammatory polyarthritis: a ten-year follow up study of a primary care-based inception cohort. Arthritis and Rheumatism. 2005; 52(8): 2293–2299.
Janet E. Pope, Ernest H.Choy, ( 2021), C-reactive protein and implications in rheumatoid arthritis and associated comorbidities, Volume 51, Issue 1, Pages 219-229
Jednacz E, Rutkowska-Sak L. (2012), Atherosclerosis in juvenile idiopathic arthritis. Mediators Inflamm. 2012: 714732.
Kayacelebi AA, Willers J, Pham VV et al. (2015) Plasma homoarginine, arginine, asymmetric dimethylarginine and total homocysteine interrelationships in rheumatoid arthritis, coronary artery disease and peripheral artery occlusion disease. Amino Acids.47(9):1885-91. doi: 10.1007/s00726-015-1915-3. Epub 2015 Jan 25.
L Badimon, E Peña, G Arderiu, T Padró l. (2018) C-reactive protein in atherothrombosis and angiogenesis Front Immunol , 9, p. 430, 10.3389/fimmu.2018.00430
Meissner Y, Zink A, Kekow J, et al. (2016) Impact of disease activity and treatment of comorbidities on the risk of myocardial infarction in rheumatoid arthritis. Arthritis Res Ther 18: 183. [PMC free article] [PubMed] [Google Scholar]
Nowakowska-Plaza A, Potaczek DP, Gluszko P, Unda- sA. (2014), Antibodies to N-homocysteinylated albumin and hemoglobin in patients with rheumatoid arthritis: 43(1): 17-21.
Perna M1, Roman MJ, Alpert DR, Crow MK et al. (2010), Relationship of asymmetric dimethylarginine and homocysteine to vascular aging in systemic lupus erythematosus patients. Arthritis Rheum. 62(6): 1718-1722.
Prevoo ML, van’t Hof MA, Kuper HH et al. (1995), Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 38: 44–48
Agca R, Heslinga S C, Rollefstad S, Heslinga M, McInnes I B, Peters M J L, Kvien T K, Dougados M, Radner H, Atzeni F, Primdahl J, Södergren A, Wallberg Jonsson S, van Rompay J, Zabalan C, Pedersen T R, Jacobsson L, de Vlam K, Gonzalez- M A Gay, A G Semb, G D Kitas, Y M Smulders, Z Szekanecz, N Sattar, D P M Symmons, M T, (2017), EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update, Ann Rheum Dis 2017;76:17–28. doi:10.1136/annrheumdis-2016-209775
Rezuș E, Floria M, Grigoriu A, Tamba BI, Rezus C. (2015), Cardiovascular Risk Factors In Chronic Inflammatory Rheumatic Diseases: Modern Assessment And Diagnosis. Curr Vasc Pharmacol. [Epub ahead of print] PMID: 25563857 [PubMed - as supplied by publisher]
Selhub J. (2006), The many facets of hyperhomocysteinemia: studies from the Framingham cohorts. J Nutr. 2006; 136(6): 1726-1730.
Slot O. (2013), Homocysteine, a marker of cardiovascular dis- ease risk, is markedly elevated in patients with gout. Ann Rheum Dis. 72(3): 457.
Szekanecz Z, Kerekes G, Der H, Sandor Z et al. (2007), Accelerated atherosclerosis in rheumatoid arthritis. Ann N Y Acad Sci. 2007; 1108: 349-358. 19.
Van den Hoek J, Boshuizen HC, Roorda LD, Tijhuis GJ, Nurmohamed MT, van den Bos GAM, et al. (2017), Mortality in patients with rheumatoid arthritis: a 15-year prospective cohort study. Rheumatol Int.;37(4):487–93.
Van Ede AE, Laan RF, Blom HJ, Boers GH et al. (2002), Homo- cysteine and folate status in methotrexate-treated patients with rheumatoid arthritis. Rheumatology.; 41(6): 658-665.
Vasiljevic D, Tomic-Lucic A, Zivanovic S, et al. (2015), Plasma homocysteine concentrations in patients with Rheumatoid arthritis. Serbian Journal of Experimental and Clinical Resear
Published
2022-11-09
How to Cite
YOUNIS , S. S., ISSA, N. K., & SULAIMAN, D. M. (2022). HOMOCYSTEINE LEVEL STATUS IN PATIENTS WITH RHEUMATOID ARTHRITIS IN DUHOK: IN RELATION TO DISEASE. ACTIVITY SCORE. Journal of Duhok University, 25(2), 57-64. https://doi.org/10.26682/sjuod.2022.25.2.6
Section
Pure and Engineering Sciences
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