دراسة بعض المعلمات المناعية و الكيموحيوية في المصابات بالتهاب المفاصل الذئبي

Study of Some Immunological and Biochemical Parameters in Females Infected with Lupus Arthriti

Abstract

Lupus arthritis is a synovitis that affects two or more joints and is characterized by swelling, effusion, or pain in two or more joints that lasts at least 30 minutes in the morning. Up to 90% of SLE patients will experience musculoskeletal involvement, making it one of the condition’s most prevalent symptoms.

This study investigated the serum level of Osteoprotegerin (OPG), β-crosslaps (β-CTX), Osteocalcin (OC) and Vitamin D3 (Vit-D3) in patient with lupus arthritis. Measure the effect of disease severity on the serum levels of (OPG, β-CTX, OC and Vit-D3). To assess the specificity and sensitivity, cut off value of the factors. Evaluated the correlation of these factorion with Age, Body mass index, anti-nuclear antibody, Anti-double strand deoxyribonucleic acid (dsDNA), C3, C4, CBC, ESR, S.Ca+, B.Urea and S.Cr.

This case-control study was conducted on 131 SLE women and 50 healthy individuals over a period of 4 months, from November 2022 until March 2023. SLE women included in this study were collected from Baghdad hospital in Medical City, Baghdad governor. The practical part occurred at the research laboratories of the International Center for Research and Development located in the city of Kadhimiya and the teaching laboratories in the Medical City. All SLE women who were included in the study were subjected to physical examination, age, BMI, and laboratory investigations, including urine examination, ANA, ds-DNA, BUN, S.Cr, ESR, dsDNA, C3, C4, and S.Ca+. Clinical examinations were conducted depending on the specialty of the consultant doctor, and they were categorized according to the Roma Helper program into three groups (inactive N=30, mild & moderate N=49 and severe N=52) according to the disease severity.

Results of the OPG and β-CTX levels were significantly increased in lupus arthritis while OC and Vit-D3 levels were significantly decreased. The OPG and β-CTX levels were positive correlation with disease activity while OC and Vit-D3 levels were negative correlation with disease activity. β-CTX showed excellent diagnostic performances for lupus arthritis where results shown AUC (0.99), sensitivity (0.99), specificity (0.70), cut‐off points (905.78) and (p < 0.001). The correlation of OPG with ANA, ESR, S,Cr and Vit-D3 where positive correlation while OPG with β-CTX were negative correlation. The correlation of OC with C3, Age, HB, β-CTX, OPG where positive correlation while OC with BMI was negative correlation. The result of Vit-D3 were positive correlation with RBC and β-CTX, While negative correlation with C3 and HB. The result of β-CTX were positive correlation with S.Cr, BUN, ESR, WBC, RBC, OC, Ca+ and Vit-D3,While negative correlation with OPG and ANA. In conclusion the OPG and β-CTX levels were significantly increased in lupus arthritis while OC and Vit-D3 levels were significantly decreased. In conclusion β-CTX was good indicator for severity of lupus arthritis.