Immunological Risk Factors Analysis Of Patients With Rheumatoid Arthritis And Positive Thyroid Peroxidase Antibody

Objective:By exploring the clinical and immunological characteristics of primary rheumatoid arthritis(RA)with TPOAb positive patients,analysis of the immunological risk factors of arthritis patients with TPOAb positive patients,aims to further explore the immunological pathogenesis of Hashimoto thyroiditis.Method:Selected 67 primary RA patients admitted in the Rheumatology Department of the Second Hospital of Shanxi Medical University from July 2019 to September 2022 as the study subjects,and the clinical and laboratory data of 67 patients with primary RA were retrospectively analyzed.RA was diagnosed based on the new RA classification criteria proposed by the American Rheumatology Consortium in 2009.The selected 67 patients with primary RA were classified into TPOAb positive(TPOAb > 9U/ml)and TPOAb negative(TPOAb≤9U/ml)based on TPOAb levels.Comparing the differences in clinical data,biochemical indicators and immunological indicators between the two groups.Univariate Logistic-analysis and multivariate Logistic regression models were used to analyze the factors affecting serum TPOAb levels in patients with naive rheumatoid arthritis.Results:In the 67 patients with primary RA,25 were TPOAb positive,and the TPOAb positive rate was 37.3%.The TPOAb-positive group in female proportion,TGAb,RF-Ig A,RF-Ig G,Bcell/Treg and IL-17 significantly higher than that in the TPOAb-negative group(P<0.05).The TPOAb-positive group in Th,Th17,Treg and CRP significantly under than that in the TPOAb-negative group(P < 0.05).Univariate Logistic regression analysis showed that: Sex was female(OR=5.250,95%CI: 1.537-17.937,P=0.008),Bcell/Treg(OR=1.131,95%CI: 1.022-1.252,P=0.018),IL-17(OR=1.097,95% CI: 1.011-1.191,P=0.026),RF-Ig A(OR=3.0,95%CI: 1.076-8.366,P=0.036),RF-Ig G(OR=4.179,95%CI:1.430-12.211,P=0.009)was a risk factor for TPOAb positivity.CRP(OR=0.972,95%CI:0.949-0.996,P=0.022),Th cells(OR=0.997,95%CI: 0.994-0.999,P=0.015),Th17(OR=0.839,95%CI: 0.720-0.978,P=0.025),Treg cells(OR=0.937,95%CI: 0.891-0.986,P=0.012)was a protective factor for TPOAb positivity.Multivariate Logistic regression analysis showed that: IL-17(OR=1.140,95%CI: 1.013-1.283,P=0.030)was an independent risk factor for TPOAb positivity;CRP(OR=0.947,95%CI: 0.904-0.991,P=0.019)and Th17(OR=0.762,95%CI: 0.585-0.994,P=0.045)were protective factors for TPOAb positivity.Conclusion:The TPOAb positive rate of primary RA patients was 37.3%.High IL-17 levels and low CRP levels were independent risk factors for serum TPOAb positivity in primary RA patients.Further explore the relationship between TPOAb levels and Th 17 cells,IL-17,and CRP,may help to elucidate the specific immunological mechanisms underlying the elevated TPOAb levels in patients with primary RA.