| Background:Rheumatoid arthritis(RA)is a chronic and progressive autoimmune disease involving synovial tissue of the joints,accompanied by pannus hyperplasia and progressive bone destruction,resulting in loss of joint function.The main etiology and pathogenesis are still unclear.Studies have shown that silent information regulatory Factor 1(SIRT1)is a deacetylase that inhibits the aggressive and inflammatory response of RA fibroblastic synoviocytes by inhibiting the NF-κB pathway.Previous studies have found that SIRT1 has certain clinical value in the diagnosis of RA.By detecting SIRT1 levels in the serum of the subjects,this study compared the expression differences between patients with RA and patients with other arthroinflammatory diseases and autoimmune diseases,and further explored the correlation between SIRT1 and disease activity of RA.Purpose:To investigate the clinical significance of serum SIRT1 in the diagnosis of RA patients and its correlation with disease activity in RA patients.Method:The experimental group included 208 RA patients in a large Class A hospital in Nanchang;In the disease control group,397 patients without RA were included,including 69 patients with ankylosing spondylitis(AS),90 patients with osteoarthritis(OA),57 patients with gouty arthritis(GA),93 patients with Sjogren’s syndrome(SS)and 88 patients with systemic lupus erythematosus(SLE).The healthy control group included 62 healthy subjects who underwent physical examination during the same period.SIRT1 and anti-mutant citrulline vimentin antibody(MCV)were detected by ELISA,anti-cyclic citrulline polypeptide antibody(CCP)and anti-RA33 antibody(RA33)were detected by chemiluminescence method,and rheumatoid factor(RF)was detected by rate scattering turbidimetric method.The results were analyzed statistically and evaluated clinically.In addition,RA patients were further divided into remission group,low activity group,moderate activity group and high activity group according to disease activity score 28(DAS28),and the correlation between DAS28 score and SIRT1 in different groups was compared.Results:(1)There was no significant difference in age and sex between the experimental group,disease control group and healthy control group(P>0.05).(2)Serum SIRT1,CCP and MCV levels of the experimental group were significantly higher than those of disease control group and healthy control group by non-parametric Kruskal-Wallis test,and the differences were statistically significant(P<0.05).(3)The specificity of SIRT1 for RA diagnosis was 94.1%,and the sensitivity of MCV for RA diagnosis was 82.7%,both of which were the highest among all the indicators detected in this study.In ROC curve,except RA33,AUCs such as SIRT1,CCP and MCV were all between 0.7 and 0.9,indicating high test accuracy.(4)The Yoden index of SIRT1 and CCP in parallel detection was 0.81(sensitivity 94.6%,specificity 86.5%),which was the highest among all combinations.(5)SIRT1 was positively correlated with DAS28(P<0.01),and the same trend was also shown in low and medium activity groups,with correlation coefficients of 0.819 and 0.623(P<0.01).Conclusion:The level of SIRT1 is significantly increased in RA patients,showing high clinical value in the diagnosis of RA.The combined detection of SIRT1 with autoantibodies,such as CCP,MCV and RA33,can further improve its diagnostic efficacy.At the same time,SIRT1 was also positively correlated with disease activity in patients with RA.With the progression of RA disease,serum SIRT1 levels in patients also increased gradually.This study indicates that SIRT1 has certain clinical application value in the diagnosis and disease monitoring of RA. |
