Neopterin as a Surrogate Marker for Coronary Artery Disease in Rheumatoid Arthritis

Maryam K. Khaery; Rana A. Hamdi

doi:10.32007/jfacmedbaghdad2376

المؤلفون

مريم خيري جامعة بغداد
Rana A. Hamdi Department of Clinical Biochemistry, College of Medicine, University of Baghdad, Baghdad, Iraq

DOI:

https://doi.org/10.32007/jfacmedbaghdad2376

الكلمات المفتاحية:

High-sensitivity C-reactive protein، Neopterin، Obesity، Rheumatoid arthritis، Coronary artery disease

الملخص

Background: Rheumatoid arthritis is an inflammatory illness. A complication of Rheumatoid arthritis is mainly linked to the risk of cardiovascular disease. High body weight has been implicated as a perilous risk factor for the development of Rheumatoid arthritis. Neopterin is secreted by monocytes and macrophages and is highly secreted from the coronary plaque. Moreover, high-sensitivity C-reactive protein is a biochemical analysis applied to quantify C-reactive protein with high sensitivity.
Objectives: To evaluate serum Neopterin and high-sensitivity C-reactive protein in patients with rheumatoid arthritis to predict the risk of coronary artery disease. In addition, a correlation between neopterin and high-sensitivity C-reactive protein and anthropometric measures.
Methods: The study included 120 women, 60 of whom had rheumatoid arthritis and 60 of whom were controls. Serum analysis included measuring neopterin, determining the sensitivity of C-reactive protein, and estimating anthropometric measurements. Pearson's correlation between two quantitative variables was computed, and a t-test was applied. The correlation coefficient value demonstrates a positive or negative relation.
Results: The patients had significantly higher mean values of serum Neopterin, high-sensitivity C-reactive protein, body mass index, waist circumference, and waist-to-hip ratio compared to controls. were detected in the patient group, significant positive correlations were found between serum Neopterin and high-sensitivity C-reactive protein, as well as body mass index, waist circumference, and waist-to-hip ratio.
Conclusion: The inflammatory markers neopterin and high-sensitivity C-reactive protein levels are higher in rheumatoid arthritis patients. The higher serum levels of these markers reflected the elevated level of systemic inflammation, and the patient was at risk of coronary artery disease. Also, there is a higher prevalence of obesity and overweight in rheumatoid arthritis patients and a positive correlation between neopterin levels and high anthropometric measures, which reflects an association between Neoperin and risk factors of coronary artery disease.

السيرة الشخصية للمؤلف

مريم خيري، جامعة بغداد

bio

المراجع

1. Oglah AA, Mohammed KIA, Alosami MH. A comparative study of serum amyloid A2 with anti-cyclic citrullinated peptide antibody in the prognosis of a group of rheumatoid arthritis patients in Iraq. J Fac Med Baghdad. 2022;64(3):153-8https://doi.org/10.32007/jfacmedbagdad.6431947.

2. Omran RH, Zahra'a AA, Alrawi AA. Evaluation of Some New Cytokines in Rheumatoid Arthritis. J Fac Med Baghdad. 2022;64(3):159-62. https://doi.org/10.32007/jfacmedbagdad.6431963.

3. Jassim NA, Redha AA. Challenges in applying treat to target strategy in sample of Iraqi patients with rheumatoid arthritis. MJR. 2021;32(4):331. https://doi.org/10.31138/mjr.32.4.331.

4. Castillo-González W. Kinesthetic treatment on stiffness, quality of life and functional independence in patients with rheumatoid arthritis. AG Salud. 2023;1:20-.https://doi.org/10.62486/agsalud202320

5. Al-Hashimi NH, Al-Gebori AM, Alosami MHM. Evaluation of the human pulmonary activation-regulated chemokine (CCL18/PARC) and alkaline phosphatase (ALP) levels in Iraqi patients with rheumatoid arthritis. IJS. 2020:713-9. https://doi.org/10.24996/ijs.2020.61.4.1.

6. Dessie G, Tadesse Y, Demelash B, Genet S. Assessment of serum lipid profiles and high-sensitivity C-reactive protein among patients suffering from rheumatoid arthritis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study. Open Access Rheumatology: Research and Reviews. 2020:223-32.https://doi.org/10.2147/OARRR.S264466

7. van de Vyver M. Immunology of chronic low-grade inflammation: relationship with metabolic function. Journal of Endocrinology. 2023;257(1).https://doi.org/10.1530/JOE-22-0271.

8. Sivaprasad R, Gopalakrishnan M, Khichar S, Shukla R, Shukla K, Garg M. Ab0274 Effect of rheumatoid arthritis on bone mineral density and its relationship with inflammatory milieu in patients with rheumatoid arthritis. BMJ Publishing Group Ltd; 2023. https://doi.org/10.1136/annrheumdis-2023-eular.4355

9. Løfblad L, Hov GG, Åsberg A, Videm V. Inflammatory markers and risk of cardiovascular mortality in relation to diabetes status in the HUNT study. Scientific Reports. 2021;11(1):15644. https://doi.org/10.1038/s41598-021-94995-8.

10. Banait T, Wanjari A, Danade V, Banait S, Jain J. Role of high-sensitivity C-reactive protein (Hs-CRP) in non-communicable diseases: a review. Cureus. 2022;14(10). https://doi.org/10.7759/cureus.30225.

11. Fadhil NM. Evaluation of serum Podocalyxin in Iraqi women with polycystic ovary syndrome. J Fac Med Baghdad. 2022;64(4):276-9. https://doi.org/10.32007/jfacmedbagdad.6441983.

12. Parker MJ, Oldroyd A, Roberts M, Lilleker J, Betteridge Z, McHugh N, et al. The performance of the EULAR/ACR Idiopathic Inflammatory Myopathies classification criteria in an expert-defined ten-year incident cohort. Rheumatology. 2018. https://doi.org/10.1136/annrheumdis-2018-eular.6056

13. Heneberk O, Wurfelova E, Radochova V. Neopterin, the cell-mediated Immune Response Biomarker, in Inflammatory Periodontal diseases: a narrative review of a more than fifty Years Old Biomarker. Biomedicines. 2023;11(5):1294. https://doi.org/10.3390/biomedicines11051294.

14. Walid H, Abdulhadi GH, Munshid MH. Levels of VCAM-1 and ICAM-1 in serum of active and inactive Systemic Lupus Erythematosus patients as biochemical markers for risk of cardiovascular disease. J Fac Med Baghdad. 2023;65(4). https://doi.org/10.32007/jfacmedbagdad.1952

15. Ekin S, Sivrikaya A, Akdağ T, Yilmaz S, Gülcemal S. Elevated levels of neopterin and pentraxin 3 in patients with rheumatoid arthritis. Hormone Molecular Biology and Clinical Investigation. 2021;42(4):419-23. https://doi.org/10.1515/hmbci-2021-0012.

16. Husein MM, Mansoor A. Serum level assessment of serum level of Neopterin (NP) and Anti-Cyclic Citrullinated Peptide (ACCPA) Antibody as markers of disease severity in rheumatoid arthritis. IJPH. 2019;10(02). https://doi.org/10.5958/0976-5506.2019.00428.5.

17. Watanabe T. Neopterin derivatives–a novel therapeutic target rather than biomarker for atherosclerosis and related diseases. Vasa. 2020.https://doi.org/10.1024/0301-1526/a000903

18. Albabawaty NS, Majid AY, Alosami MH, Mahmood HG. Role of high sensitivity C-Reactive protein and some of heavy metals in patients with rheumatoid arthritis. Ann Trop Med Public Health. 2020;23:16. https://doi.org/10.36295/ASRO.2020.231604.

19. Kashyap B, Goyal N, Singha k Tajuddin M, Singh M, Avasthi R. Correlation of hs-CRP Levels with Anti-CCP And Rheumatoid Factor Among Clinically Suspected Rheumatoid Arthritis Cases: A Predictor for Early Inflammation. Ann Pathol Lab Med. 2019;6:482-6. https://doi.org/10.21276/apalm.2651

20. Ke J-F, Wang J-W, Lu J-X, Zhang Z-H, Liu Y, Li L-X. Waist-to-height ratio has a stronger association with cardiovascular risks than waist circumference, waist-hip ratio and body mass index in type 2 diabetes. Diab Res. 2022;183:109151. https://doi.org/10.1016/j.diabres.2021.109151.

21. Oussaada SM, Van Galen KA, Cooiman MI, Kleinendorst L, Hazebroek EJ, van Haelst MM, et al. The pathogenesis of obesity. Metabolism. 2019;92:26-36. https://doi.org/10.1016/j.metabol.2018.12.012.

22. Ohno T, Aune D, Heath AK. Adiposity and the risk of rheumatoid arthritis: a systematic review and meta-analysis of cohort studies. Scientific reports. 2020;10(1):16006.. https://doi.org/10.1038/s41598-020-71676-6

23. Guimarães MFBdR, Rodrigues CEM, Gomes KWP, Machado CJ, Brenol CV, Krampe SF, et al. High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study. Advances in Rheumatology. 2019;59:44. https://doi.org/10.1186/s42358-019-0089-1.

24. Wan R-H, Yuan Y, Hao W, Zheng L-Y, Lu J. Relationship between serum neopterin level and peripheral arterial plaque in patients with type 2 diabetes. Diabetes, Metabolic Syndrome and Obesity. 2021:2871-8. https://doi.org/10.2147/DMSO.S315986.

25. Andonian B, Ross LM, Zidek AM, Fos LB, Piner LW, Johnson JL, et al. Remotely Supervised Weight Loss and Exercise Training to Improve Rheumatoid Arthritis Cardiovascular Risk: Rationale and Design of the Supervised Weight Loss Plus Exercise Training‐Rheumatoid Arthritis Trial. ACR Open Rheumatology. 2023;5(5):252-63. https://doi.org/10.1002/acr2.11536.

26. Mandviwala T, Khalid U, Deswal A. Obesity and cardiovascular disease: a risk factor or a risk marker? Current atherosclerosis reports. 2016;18:1-10. https://doi.org/10.1007/s11883-016-0575-4.