The correlation of serum suPAR,BDNF,sTWEAK levels and disease activity and bone density in patients with rheumatoid arthritis
Objective To investigate the correlation between serum levels of soluble urokinase-type plasminogen activator re-ceptor(suPAR),brain-derived neurotrophic factor(BDNF),soluble tumor necrosis factor-like weak inducer of apoptosis(sTWEAK)and disease activity and bone density in patients with rheumatoid arthritis.Methods We enrolled 140 patients with rheumatoid ar-thritis(patient group)admitted to the Endocrinology Department of the 940 Hospital of the Joint Logistics Support Force from January 2021 to July 2023 were selected and 70 healthy individuals(control group)who underwent physical examinations at our medical examina-tion center from January 2021 to July 2023.The activity of rheumatic diseases was evaluated,and bone density was measured.The serum levels of suPAR,BDNF,and sTWEAK were detected in the control and patient groups.According to the level of activity of rheumatic dis-eases,the patient group was further divided into three subgroups:high,medium,and low groups.The suPAR,BDNF,sTWEAK,and bone density were compared between the patient group and the con-trol group,and among three subgroups(low,medium,and high groups).The correlation of suPAR,BDNF,sTWEAK and disease activi-ty,bone density was analyzed.The value of combined detection of suPAR,BDNF,and sTWEAK in predicting the risk of disease pro-gression was analyzed.Results The serum levels of suPAR(3.04±0.33 ng/mL),BDNF(10.36±1.21 ng/mL),and sTWEAK(152.12±15.47 pg/mL)in the patient group were higher than those in the control group(1.35±0.16 ng/mL,5.76±0.69 ng/mL,92.46±9.52 pg/mL)(P<0.05).The comparison of serum levels of suPAR,BDNF,and sTWEAK showed that the high group>moderate group>low group(P<0.05).The bone densities of the distal forearm(0.71±0.08 g/cm3),lumbar spine L1-4(0.94±0.12 g/cm3),femoral neck(0.90±0.10 g/cm3),and hip joint(0.83±0.09 g/cm3)in the patient group were lower than those in the control group(0.89±0.09 g/cm3,1.16±0.14 g/cm3,1.08±0.12 g/cm3,1.13±0.14 g/cm3)(P<0.05).The comparison of bone densities of the distal forearm,lumbar vertebrae L1-4,femoral neck,and hip joints showed that high group<moderate group<low group(P<0.05).SuPAR,BDNF,and sTWEAK were positively correlated with disease activity,and negatively correlated with bone densities of the distal forearm,lumbar spine L1-4,femo-ral neck,and hip joints(P<0.05).The combination of suPAR,BDNF,and sTWEAK showed a higher AUC(0.914)in predicting the risk of increased disease activity compared to the single predicted AUC(0.769,0.799,0.785)(P<0.05).Conclusion SuPAR,BDNF,and sTWEAK are positively correlated with disease activity and negatively correlated with bone density in patients with rheuma-toid arthritis.Combined detection of suPAR,BDNF,and sTWEAK can provide effective guidance for predicting disease trends in pa-tients.
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