Division of Rheumatology, Department of Internal Medicine, Arthritis and Autoimmunity Research Center, Catholic University of Daegu School of Medicine, 3056-6 Daemyung 4-Dong, Namgu, Daegu 705-718, Republic of Korea.
Rheumatol Int. 2013 Sep;33(9):2373-9. doi: 10.1007/s00296-013-2734-z. Epub 2013 Apr 4.
To analyze the association of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP) with non-remission and with disease activity measures in rheumatoid arthritis (RA). Cross-sectional study of consecutive RA patients. Non-remission was defined as a disease activity score (DAS28) ≥ 2.6 at study enrollment. The Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) were additionally measured. Serum titers of RF and anti-CCP were transformed into incremental levels (100/units) and log-transformed levels. Analysis of association with non-remission was done with logistic regression models, with and without adjustment for age, sex, disease duration, and corticoid use. Multiple regression models, raw and similarly adjusted, were used to measure the association of RF and anti-CCP with the disease activity measures. A total of 385 patients were included, of whom 286 (74 %) were not in remission. Log-transformed RF level was associated with an increased risk of non-remission after adjustment (OR = 1.32, 95 % CI 1.04-1.67). This association was especially evident in patients with less than 10 years of disease duration (OR = 1.51, 95 % CI 1.15-1.99) and in those using steroids (OR = 2.06, 95 % CI 1.22-3.48). Serum RF titers and log-transformed RF levels showed a small but significant association with DAS28 score (adjusted beta coefficients 0.002 and 0.18, respectively; both p ≤ 0.01), but neither with SDAI or CDAI nor with anti-CCP antibody. : Log-transformed RF levels might be associated with non-remission in RA, especially in patients with short disease duration or on steroids.
分析类风湿因子（RF）和抗环瓜氨酸肽抗体（抗-CCP）与类风湿关节炎（RA）未缓解和疾病活动指标的相关性。这是一项连续 RA 患者的横断面研究。未缓解定义为研究入组时疾病活动评分（DAS28）≥2.6。还测量了简化疾病活动指数（SDAI）和临床疾病活动指数（CDAI）。RF 和抗-CCP 的血清滴度转换为增量水平（100/单位）和对数转换水平。使用逻辑回归模型，在不调整和调整年龄、性别、疾病持续时间和皮质激素使用的情况下，分析与未缓解的相关性。使用原始和类似调整的多元回归模型来测量 RF 和抗-CCP 与疾病活动指标的相关性。共纳入 385 例患者，其中 286 例（74%）未缓解。调整后，RF 对数转换水平与未缓解的风险增加相关（OR=1.32，95%CI 1.04-1.67）。这种关联在疾病持续时间小于 10 年的患者（OR=1.51，95%CI 1.15-1.99）和使用类固醇的患者中更为明显（OR=2.06，95%CI 1.22-3.48）。血清 RF 滴度和 RF 对数转换水平与 DAS28 评分呈微弱但显著的相关性（调整后的β系数分别为 0.002 和 0.18；均 p≤0.01），但与 SDAI 或 CDAI 或抗-CCP 抗体均无相关性。结论：RF 对数转换水平可能与 RA 的未缓解相关，尤其是在疾病持续时间短或使用类固醇的患者中。
