Relationship Between Serum Level of Homocysteine, Leptin and Neopterin and Disease Activity in Rheumatoid Arthritis patients with or without Extra-articular Manifestations

Gazar, Yasser A.Elmotaleb; Gamal, Mohammed; Ghait, Mohammed M.

doi:10.21608/mjmr.2022.218162

Relationship Between Serum Level of Homocysteine, Leptin and Neopterin and Disease Activity in Rheumatoid Arthritis patients with or without Extra-articular Manifestations

Document Type : Original Article

Authors

¹ Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

² Department of Rheumatology and Rehabilitation, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

10.21608/mjmr.2022.218162

Abstract

Objectives: this study was aimed to determine serum homocysteine, leptin and neopterin levels
in patients with RA and investigate the relationship between clinical and laboratory parameters
of disease activity and presence or absence of extra- articular manifestations. Patients and
methods: Thisstudy included 80 RA patients(16 males, 64 females; mean age 34.5±10.8 years;
range 24.5 to 45.3 years) and age and sex-matched 80 healthy controls (16 males, 64 females,
mean age 30.8 ± 10.4 range 20 to 65). RA patients were divided into two groups (A&B)
depending on the presence or absence of Extra-articular manifestations. Of the patients, there
was 40 patients with no Extra-articular while the other 40 with Extra-articular (9 patients with
Cutaneous vasculitis, 7 with Nodules, 6 with Neuropathy, 5 with Reynaud's phenomenon ,7
with 2
ndry. Sjogren, 2 with Fealty’s syndrome, 2 with Interstitial nephritis, 2 with Interstitial
lung disease). Results: In the RA group (A+B), mean serum Hcy, leptin and neopterin levels
were (11.79 + 8.72 μmol/L), (22.43 ± 7.37 ng/ml) & (3.83±1.84 nmol/L) respectively with No
statistically significant difference was found between RA and control groups regarding serum
Leptin (p=0.674). While a significant difference was found between RA and control groups
regarding serum Neopetrin (< 0.001) &Hcy. (< 0.001). Also, In RA groups (A, B) there was a
statistically significant difference regarding serum Neopterin (p< 0.03) and DAS 28 ESR (p<
0.05). there was a Positive significant correlation between serum (neopterin - Hcy) and ESR,
TNF-α, IL-6, and DAS-28 (p < 0.05) while no significant correlation was found between serum
(neopterin- Hcy) and CRP (p > 0.05). Conclusion: Serum leptin cannot be considered of value
as an inflammation marker in monitoring RA patients while Serum neopterin can be used as a
sensitive marker for assaying background inflammation and disease activity score in RA
patients while serum homocysteine can be used as a marker for probability of extra articular
complication of RA.

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