The Blood Glucose Levels Correlated With Disease Activity In Rheumatiod Arthritis Patients With Type 2 Diabetes Mellitus

Purpose:Rheumatoid arthritis(RA)is a common chronic autoimmune disease in clinical practice,most of which are with synovial joint damage.As the disease progresses,it can cause the loss of joint function and even disability.As a systemic disease,RA can also cause damage to other systems,such as heart disease,pulmonary interstitial fibrosis,liver and kidney damage,pleurisy,anemia,and peripheral neuropathy,etc.The pathogenesis of RA has not yet been fully elucidated,and clinically there is no effective cure for the disease up to now.Recently,the incidence of type 2 diabetic mellitus(T2DM)in RA patients has increased,which has gradually attracted more attention from the public.However,similar to RA,T2DM is also an immune-related disease,of which the mechanism is not very clear yet.The treatment for patients with these two diseases is quite complicated and it often requires lifelong medication.If the treatment is not standardized,the progression of the disease will cause cardiovascular disease and seriously affect the prognosis.By detecting blood glucose levels and related clinical indicators in patients with both RA and T2DM,analyzing the.effects of blood glucose levels on the disease activity degree.Methods:This study randomly selected 90 patients with RA and T2DM who were admitted to our hospital from June 2015 to September 2019,all of whom were divided into a control group with low blood glucose level and an a research group with high blood glucose level based on their fasting blood-glucose(FBG)level.With 45 patients in each group,the average age,body mass index(BMI)and other general clinical indicators of the two groups were with no significant differences.In this study,FBG,glycated hemoglobin(GHb),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),rheumatoid factor(RF)of the control group and the research group were all detected.Enzyme linked immunosorbent assay(ELISA)was used to detect the concentrations of fibrinogen and anti-cyclic citrullinated peptide antibody(ACPA)in the serum of the two groups of patients.The D-dimer in the serum of the two groups of patients was detected by immunoturbidimetry and the disease range of motion scores for 28 joints(DAS28)of the two groups of patients was calculated.Pearson Correlation Analysis was used to analyze the correlation between blood glucose levels and DAS28.Results:(1)The concentration of FBG in the control group and research group was 6.38 �1.35 mmol/L and 10.48 � 2.01 mmol/L,respectively.As comparison with the control group,the concentration of FBG in the research group was significantly higher(p<0.01).The concentrations of GHb,CRP,ESR,RF and ACPA in the control group were 6.73%�2.92%,35.27 � 12.67 mg/L,39.84 �28.17 mm/h,134.21 � 63.83 U/mL,508.34� 473.48 RU/mL.The concentrations of FBG,GHb,CRP,ESR,RF and ACPA in the research group were 8.68%� 2.37%,46.13 � 19.56 mg/L,51.64 � 26.71 mm/h,163.99 � 70.93 U/mL,728.81 � 504.26 RU/mL.All the above indicators of the patients in the research group were significantly increased(p<0.05).(2)Serum fibrinogen concentrations in the control group and research group were 4.67 � 1.22 g/L and 5.25�1.53 g/L,respectively.As comparison with the control group,the fibrinogen concentration in the research group was significantly increased(p<0.05).(3)The concentrations of D-dimer in the serum of the control and research groups were 3.81 � 2.36 g/L and 5.51 � 4.89 g/L,respectively.As comparison with the control group,the concentration of D-dimer in the research group was also significantly increased(p<0.05).(4)There were 26 cases(57.8%)in the control group and 14 cases(31.1%)in the research group with low disease activity degree.There were 10 cases(22.2%)in the control group and 13 cases(28.9%)in the research group with moderate disease activity degree.There were 9 patients(20%)in the control group and 18 patients(40%)in the research group in high disease activity degree.As comparison with the control group,the proportion of patients with low disease activity degree in the research group was significantly reduced,and the number of patients in high disease activity was significantly increased(p<0.05).These rtesults suggested that the disease activity of patients in the research group were severer than that of the patients from the control group.(5)The results based on Pearson analysis showed that the FBG level and DAS28 score were positively correlated(p<0.05).The r value between the blood glucose level and the DAS28 score of the control group was 0.304.The r value between the blood glucose level and the DAS28 score of the research group was 0.335.Conclusions:The disease activity of RA patients with T2DM with high FBG level was severer,and there was a positive correlation between them.The results of the present study provided the evidence for investigating the relationship between high FBG level disease activities in RA patients with T2DM.