Correlation between the expression levels of spalt-like transcription factor 4,olfactomedin 4 and ac-tivin A and clinical characteristics of patients with rheumatoid arthritis and their predictive value on joint deformities
Objective To explore the expression levels of serum spalt-like transcription factor 4(SALL4)mRNA,ol-factomedin 4(OLFM4)mRNA,and activin-A in patients with rheumatoid arthritis(RA),and analyze their correlation with clinical characteristics and their predictive value on joint deformities.Methods A total of 130 RA patients admitted to the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2021 to April 2023 were selected as the RA group,and 102 healthy volunteers who underwent physical examinations in the outpatient during the same period were selected as the control group.The serum Activin-A level was measured by using the enzyme-linked immunosorbent assay,and the serum SALL4 and OLFM4 mRNA levels were measured by using the reverse transcription polymerase chain reaction on the second day of admission for patients in the RA group and on the day of physical examination for patients in the control group.The serum SALL4 mRNA,OLFM4 mRNA and Activin-A levels were compared between the RA group and the control group and among the RA patients with different clinical characteristics.The influencing factors of RA combined with joint deformities were identified by using univariate and multivariate logistic regression.The receiver operating characteristic curve was used to analyze the value of SALL4 mRNA,OLFM4 mRNA and Activin-A in predicting joint deformities in RA.Results The relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients in the RA group were significantly higher than those in the control group(P＜0.05).The relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients with severe disease activity were significantly higher than those of patients with moderate and mild disease activity,and the relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients with moderate disease activity were significantly higher than those of patients with mild disease activity(P＜0.05).The relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A of patients with the number of affected joints≥10,duration of synovitis≥6 weeks,and joint deformities were significantly higher than those in patients with the number of affected joints＜10,duration of synovitis＜6 weeks,and no joint deformities(P＜0.05).There was no statistically significant difference in the relative expression levels of serum SALL4 mRNA and OLFM4 mRNA and the level of Activin-A among patients of different ages and genders(P＞0.05).The multivariate logistic regression analysis showed that the severe disease activity and elevated SALL4 mRNA,OLFM4 mRNA and Activin-A levels were risk factors for joint deformities in RA(P＜0.05).The cut-off values of Activin-A,SALL4 mRNA,and OLFM4 mRNA for predicting joint deformities in RA were 15.06 pg·L-1,3.412,and 3.802,respectively,and the areas under the curves were 0.699,0.693,and 0.756,respectively.The area under the curve for the predication of joint deformities in RA based on the combination of SALL4 mRNA,OLFM4 mRNA,and Activin-A was 0.892,which significantly higher than the prediction by the said indexes alone(Z=4.171,2.785,3.626,P＜0.05).Conclusion The increased levels of serum SALL4 mRNA,OLFM4 mRNA and Activin-A in RA patients are associated with RA disease activity,number of affected joints,duration of synovitis,and joint deformities.The combined detection of SALL4 mRNA,OLFM4 mRNA and Activin-A for predicting joint deformities in RA is more effective than the individual detection of the three.
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