Abstract：Objective To detect serum iron regulator (Hepc) and soluble iron regulator protein (s-HJV) in patients with rheumatoid arthritis complicated with chronic anemia (RA-ACD) in northern Xinjiang area, and to explore the role of Hepc and s-HJV in the pathogenesis of RA-ACD, to analyze the relationship between HEPC, S-HJV, and disease activity (DAS28). Methods From March 2021 to May 2022, a total of 120 RA-ACD patients(RA-ACD group), 120 RA patients(RA group), and 80 healthy physical examination patients(health control group) were collected from the Fourth Affiliated Hospital of Xinjiang Medical University, Altay Kazakh Medical Hospital, Altay Regional People’s Hospital, Tori Kazakh Medical Hospital, and Tori County People’s Hospital. The levels of serum Hepc, s-HJV, serum iron (SI), transferrin (Tf), ferritin (SF), interleukin 6 (IL-6), C-reactive protein (CRP), and erythrocyte settlement rate (ESR) in the above three groups were determined by double-antibody sandwich enzymosorbent immunosorbent assay, and DAS28 score was calculated. Results There were statistically significant differences in Hepc, s-HJV and Hb levels among the three groups (P＜0.05). Hepc of RA-ACD and RA groups were lower than that of control group, and RA-ACD group was lower than that of RA group; those of s-HJV in RA-ACD and RA groups were higher than that in healthy control group, and RA group was higher than that in healthy control group; Hb in RA-ACD group was lower than that in RA group and healthy control group, and the differences were statistically significant (P＜0.05). There were statistically significant differences in SI, Tf, and SF levels among the three groups (P＜0.05). The SI of RA-ACD group and RA group was lower than that of healthy control group, and RA-ACd group was higher than that of RA group; Tf in RA-ACD group and RA group was lower than that in healthy control group; The SF level of RA-ACD group was lower than that of RA group and healthy control group, and the differences were statistically significant (P＜0.05). The levels of IL-6, ESR, and CRP among the three groups were statistically significant (P＜0.05). IL-6, ESR, and CRP in RA-ACD and RA groups were higher than those in healthy control group, ESR, CRP, and DAS28 in RA-ACD group were higher than those in RA group, and the differences were statistically significant (P＜0.05). Correlation analysis showed that Hepc was positively correlated with IL-6 (r＞0, P＜0.05), and negatively correlated with DAS28 (r＜0, P＜0.05). s-HJV was positively correlated with SI, Tf, IL-6, and ESR (r＞0, P＜0.05), and negatively correlated with Hb (r＜0, P＜0.05). DAS28 was positively correlated with SI, ESR, and CRP (r＞0, P＜0.05), and negatively correlated with Hb (r＜0, P＜0.05). Hb was negatively correlated with SI, SF, ESR, CRP, and s-HJV (r＜0, P＜0.05). Conclusion Hepc and s-HJV are involved in the progression of RA-ACD disease, and s-HJV may reverse the promoting effect of inflammatory factors on Hepc expression in a compensatory way. The disease activity of RA is closely related to inflammation and anemia. The higher the level of inflammation, the more serious the disease will be, and anemia will aggravate the disease. Serum Hepc level decreased with the increase of DAS28 level, suggesting a certain correlation between Hepc and disease activity in RA patients.
[1] Giannini D，Antonucci M，Petrelli F，et al. One year in review 2020：pathogenesis of rheumatoid arthritis [J]. Clin Exp Rheumatol，2020，38（3）：387-397.
[2] McInnes IB，Schett G. Pathogenetic insights from the treatment of rheumatoid arthritis [J]. Lancet，2017，389（10086）：2328-2337.
[3] 谢岩，林翊萍.类风湿关节炎与感染相关研究进展[J].中国免疫学杂志，2021，37（15）：1919-1922.
[4] 俞建钰，陈晗，陈祥芳，等.类风湿关节炎合并慢性贫血的机制探讨[J].风湿病与关节炎，2018，7（12）：52-54.
[5] 韩曦瑶.慢性病贫血的发病机制及诊断[J].徐州医学院学报，2016，36（8）：557-560.
[6] 张梦雪，王小钦.铁稳态失调相关的炎症性贫血发病机制及诊断进展[J].诊断学理论与实践，2018，17（5）：601- 605.
[7] Sato H，Takai C，Kazama JJ，et al. Serum hepcidin level，iron metabolism and osteoporosis in patients with rheumatoid arthritis [J]. Sci Rep，2020，10（1）：9882.
[8] Wang CY，Babitt JL. Liver iron sensing and body iron homeostasis [J]. Blood，2019，133（1）：18-29.
[9] Aletaha D，Neogi T，Silman AJ，et al. 2010 Rheumatoid arthritis classification criteria： an American College of Rheumatology/European League Against Rheumatism collaborative initiative [J]. Arthritis Rheum，2010，62（9）：2569-2581.
[10] 袁钰荔，尹玉月，范惠珍.DAS28-CRP与DAS28-ESR评分在类风湿关节炎中的比较[J].实用中西医结合临床，2018，18（11）：5-6，9.
[11] Ali ET，Jabbar AS，Mohammed AN. A Comparative Study of Interleukin 6，Inflammatory Markers，Ferritin，and Hematological Profile in Rheumatoid Arthritis Patients with Anemia of Chronic Disease and Iron Deficiency Anemia[J]. Anemia，2019，2019：3457347.
[12] 刘冰，王文平，袁红亮，等.不同雷公藤制剂对类风湿关节炎贫血患者炎症、铁代谢及相关信号通路的影响比较[J].中医临床研究，2021，13（23）：18-21.
[13] Sahebari M，Rezaieyazdi Z，Hashemy SI，et al. Serum hepcidin level and rheumatoid arthritis disease activity [J]. Eur J Rheumatol，2018，6（2）：76-80.
[14] Nita E，Bairaktari E，Kolios G，et al. Role of Hepcidin in Anemia of Chronic Disease in Rheumatoid Arthritis [J]. J Lab Physicians，2021，13（4）：317-322.
[15] Khalaf W，Al-Rubaie HA，Shihab S. Studying anemia of chronic disease and iron deficiency in patients with rheumatoid arthritis by iron status and circulating hepcidin [J]. Hematol Rep，2019，11（1）：7708.
[16] van Santen S，van Dongen-Lases EC，de Vegt F，et al. Hepcidin and hemoglobin content parameters in the diagnosis of iron deficiency in rheumatoid arthritis patients with anemia [J]. Arthritis Rheum，2011，63（12）：3672-3680.
[17] Scholz GA，Leichtle AB，Scherer A，et al. The links of hepcidin and erythropoietin in the interplay of inflammation and iron deficiency in a large observational study of rheumatoid arthritis [J]. Br J Haematol，2019，186（1）：101-112.
[18] Tański W，Chabowski M，Jankowska-Polańska B，et al. Iron metabolism in patients with rheumatoid arthritis [J]. Eur Rev Med Pharmacol Sci，2021，25（12）：4325-4335.
[19] 米海潮，崔芳，杜玉涛，等.慢性病贫血铁代谢调节机制的研究进展[J].生理学报，2022，74（4）：639-647.
[20] 李堃杰.类风湿关节炎合并慢性病贫血患者血清可溶性铁调素调节蛋白水平的测定及意义[D].青海：青海大学，2015.
[21] 任燕，张斐娜.类风湿关节炎患者血红蛋白水平与疾病活动度相关性分析[J].贵州医药，2021，45（2）：183-185.
[22] 叶玉珊，毕红兵.RDW及相关炎症因子与类风湿关节炎病情活动度的关系研究[J].检验医学与临床，2021， 18（16）：2372-2375.
[23] 蔡欣荣，向阳.地中海饮食对类风湿关节炎影响的研究进展[J].临床内科杂志，2020，37（10）：749-750.
[24] 肖佳，于婧，林高节，等.饮食干预在类风湿性关节炎中的作用研究进展[J].工业微生物，2021，51（4）：48-56.
[25] 强宇靖，罗奎元，马腾茂，等.气候因素对Ⅱ型胶原蛋白所致类风湿关节炎模型大鼠关节炎症、免疫脏器指数及组织形态的影响[J].甘肃中医药大学学报，2016，33（2）：7-11.
京公网安备 11010502046598号