Rheumatology Unit, San Giovanni di Dio Hospital, USL Tuscany Centre, Florence, Italy.
Rheumatology Unit, Università Politecnica delle Marche, Jesi, Ancona, Italy.
Clin Exp Rheumatol. 2021 Jan-Feb;39(1):79-83. doi: 10.55563/clinexprheumatol/nqqx5k. Epub 2020 Mar 28.
In early undifferentiated arthritis (EUA), the relationship between inflammatory biomarkers and disability is still unclear. The aim of this study was to correlate inflammatory biomarkers with the Arthritis Impact Measurement Scales (AIMS) in EUA.
Seventy patients with EUA were compared with 20 patients with established rheumatoid arthritis (RA). The association of AIMS [mobility, physical impairment (PI), dexterity, household activities, activities of daily living (ADL), social activity, pain, anxiety, depression] with serum laboratory [phase acute reactants, calprotectin, interleukin-6, tumour necrosis factor (TNF)-α, rheumatoid factor, anti-nuclear and anti-citrullinated peptide antibodies, HLA-DRB], clinical [Clinical Disease Activity Index (CDAI), fatigue, pain and stiffness NRS], x-ray and ultrasound biomarkers was analysed with non-parametric Spearman's rank correlation and Mann-Whitney U tests.
No differences in AIMS were found between EUA and established RA patients, or between EUA patients that evolved into early RA (n=17) and those that remained EUA (n=53) at six months of follow-up. In EUA, erythrocyte sedimentation rate correlated with mobility impairment, PI and depression (p=0.04, p=0.03 and p=0.022, respectively), TNF-α correlated with PI (p=0.01) and calprotectin with anxiety (p=0.02). HLA-DRB1*11-positive EUA patients had lower ADL deficiency (p=0.006), depression (p=0.0004) and anxiety (p=0.01). CDAI correlated with PI (p=0.01) and pain (p=0.01), fatigue with PI (p=0.0001) and ADL (p=0.009), stiffness with PI (p=0.01), and Power Doppler ultrasound synovitis with PI (p=0.02) and pain (p=0.007).
In EUA, physical and mood disorders are associated with new and old inflammatory serological, clinical and imaging biomarkers. HLA-DRB1*11-positivity may be protective against these disease-related features.
在早期未分化关节炎(EUA)中,炎症标志物与残疾之间的关系尚不清楚。本研究旨在探讨 EUA 中炎症标志物与关节炎影响测量量表(AIMS)之间的相关性。
将 70 例 EUA 患者与 20 例已确诊的类风湿关节炎(RA)患者进行比较。采用非参数 Spearman 秩相关和 Mann-Whitney U 检验分析 AIMS[运动能力、身体损伤(PI)、灵巧性、家务活动、日常生活活动(ADL)、社会活动、疼痛、焦虑、抑郁]与血清实验室[急性期反应物、钙卫蛋白、白细胞介素-6、肿瘤坏死因子(TNF)-α、类风湿因子、抗核和抗瓜氨酸肽抗体、HLA-DRB]、临床[临床疾病活动指数(CDAI)、疲劳、疼痛和僵硬 NRS]、X 射线和超声生物标志物之间的相关性。
EUA 患者与已确诊 RA 患者之间,或在 6 个月随访时发展为早期 RA(n=17)的 EUA 患者与仍为 EUA(n=53)的患者之间,AIMS 无差异。在 EUA 中,红细胞沉降率与运动能力障碍、PI 和抑郁相关(p=0.04、p=0.03 和 p=0.022),TNF-α与 PI 相关(p=0.01),钙卫蛋白与焦虑相关(p=0.02)。HLA-DRB1*11 阳性的 EUA 患者 ADL 不足(p=0.006)、抑郁(p=0.0004)和焦虑(p=0.01)程度较低。CDAI 与 PI(p=0.01)和疼痛(p=0.01)相关,疲劳与 PI(p=0.0001)和 ADL(p=0.009)相关,僵硬与 PI(p=0.01)相关,Power Doppler 超声滑膜炎与 PI(p=0.02)和疼痛(p=0.007)相关。
在 EUA 中,躯体和情绪障碍与新的和旧的炎症血清学、临床和影像学生物标志物相关。HLA-DRB1*11 阳性可能对这些与疾病相关的特征具有保护作用。