title: Association of homocysteine with immunological-inflammatory and metabolic laboratory markers and factors in relation to hyperhomocysteinaemia in rheumatoid arthritis.
abstract: OBJECTIVE
  The increase of homocysteine (Hcy) is an independent risk factor related to the development of atherosclerosis (AS) and the cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). Cardiovascular disease is a leading cause of mortality in RA. The aim of the study was to determine its relationship with homocysteine and the clinical immunological-inflammatory and metabolic laboratory markers and evaluate the factors in relation to hyperhomocysteinaemia in RA.
  
  
  METHODS
  Analysis of total serum homocysteine (Hcy) concentrations was carried out in fifty patients with RA compared with 50 matched health controls. In patients with RA, numerous immunological-inflammatory and metabolic laboratory makers included, folate, vitamin B12 complement (i.e. C3 and C4), C-reactive protein (CRP), Rheumatoid factor (RF), anticyclic citrullinated peptide (anti-CCP) antibody, cystatin C (CysC), triglycerides, cholesterol and total leukocyte count. We also assessed imaging makers, common carotid intima-media thickness (IMT) and disease activity makers such as Disease Activity Score in 28 joints (DAS28).
  
  
  RESULTS
  Median concentration of Hcy was significantly greater in patients with RA than in controls: 9.09 (5.38-33.91) vs. 7.45 (4.89-25.77) μmol/L (p<0.001). In RA patients, homocysteine was inversely associated with folate (rho=-0.672, p<0.0001), vitamin B12 (rho=-0.424, p=0.002), C3 (rho=-0.612, p<0.0001), C4 (rho=-0.323, p=0.022), correlate with CRP (rho=0.342, p=0.015), CysC (rho=0.430, p=0.002), but not with anti-CCP antibody (rho=0.205, p=0.152), RF (rho=0.214, p=0.135), triglycerides (rho=-0.107, p=0.459), cholesterol (rho=0.160, p=0.268), total leukocyte count (rho=-0.157, p=0.276), IMT (rho=0.134, p=0.156), DAS28 (rho=0.211, p=0.148). There was association between hyperomocysteinaemia in RA with vitamin B12 (p=0.037), folate (p<0.001), and CRP (p=0.018). There was no association with male gender, anti-CCP antibody, RF, IMT and DAS28.
  
  
  CONCLUSIONS
  Results from this study suggested that Hcy concentration was increased in RA patients and associated with RA-related immunological-inflammatory and metabolic laboratory markers, including folate, vitamin B12, CRP, CysC, C3, C4. Early determination of Hcy and correlated clinical laboratory markers may be useful to evaluate RA patients with high cardiovascular risk.
authors.affiliation: Department of Laboratory Medical, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: X
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Laboratory Medical, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
authors.forename: F
authors.initials: F
authors.lastname: Gao
authors.affiliation: Department of Laboratory Medical, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. liuyanhong_sci@163.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Liu
mesh_terms: D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000453:epidemiology / Q000209:etiology / Q000276:immunology; D007249:Inflammation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015166:Monitoring, Immunologic / Q000379:methods; D010456:Peptides, Cyclic / Q000276:immunology; D012217:Rheumatoid Factor / Q000097:blood*; D012307:Risk Factors; D013223:Statistics as Topic
chemical_list: D015415:Biomarkers; D055316:Cystatin C; D010456:Peptides, Cyclic; C487763:cyclic citrullinated peptide; D006710:Homocysteine; D002097:C-Reactive Protein; D012217:Rheumatoid Factor