| Objective:To detect the expression of receptor activator of NF-JB ligand(RANKL)and angiopoietin-like protein 4(ANGPTL4)in synovial fluid and serum of patients with rheumatoid arthritis(RA),and to explore the possible role of both in RA patients’ disease progression.Methods:The serum was collected from 67 patients with rheumatoid arthritis diagnosed by outpatient and inpatient department of the First Hospital of Shanxi Medical University from January to September in 2016.The patients who were enrolled in the RA were diagnosed according to the RA classification criteria of 2010 Ollega of American Cheumatism / Europe Leagues A-gainst Rheumatism,and according to the DAS28 score,RA patients were divided into the high activity group(DAS28> 5.1),the moderate activity group(3.2 <DAS28≤5.1)and the low group(DAS28≤3.2).Serum of 20 patients with osteoarthritis(OA)and 20 out patients for heath examination were selected as the control group.At the same time,we collected the synovial fluid wich from 17 cases of RA patients and 10 cases of OA patients.The expression levels of ANGPTL4 and RANKL in serum and synovial fluid of each experimental group and control group were measured by ELISA.The possible roles of ANGPTL4 and RANKL in RA disease were analyzed,and the correlation between ANGPTL4 and RANKL was analyzed.The differences of ANGPTL4 and RANKL in RA and OA were analyzed by independent sample t test.The differences of serum ANGPTL4,RANKL in the RA group,OA group and the health group were analyzed by Mann-Whitney U test.Kruskal Wallis H test analysis RA patients serum ANGPTL4,RANKL in the activities of the differences between groups.Person correlation analysis analyzed ANGPTL4 and RANKL in serum of patients with RA and their correlation with disease activity.Results:1.The expression of ANGPTL4 and RANKL in serum of RA patients[(5.89±2.90)ng/ml,(198.14±132.3)pg/ml] were significantly higher than those of OA patients[(2.97±0.86)ng/ml,(82.32±19.40)pg/ml]and healthy controls[(2.87±0.99)ng/ml,(81.51±21.30)pg/ml](Z values:-5.720,-5.801,-5.387,-5.125;P<0.05).2.The serum levels of ANGPTL4 and RANKL in RA patients was significantly different between the high disease activity group[(8.18±3.81)ng/ml,(309.47±162.25)pg/ml]and the moderate disease activity group[(5.62±1.39)ng/ml,(191.36±63.43)pg/ml],the high disease activity group and the low disease activity group[(4.05±0.77)ng/ml,(102.03±34.22)pg/ml],the moderate disease activity group and the low disease activity group(H values:11.082,9.976;29.511,30.708;19.485,23.483;P<0.05).3.There was a positive correlation between the serum levels of ANGPTL4 and RANKL in RA patients(r=0.979,P<0.05),and the both had a positive correlation between the age,course of disease,ESR,CRP,joint swelling,joint tenderness and DAS28 score in RA patients(r values:0.315,0.300;0.465,0.444;0.624,0.634;0.288,0.295;0.722,0.740;0.683,0.726;0.682,0.727;P<0.05)4.The levels of ANGPTL4 and RANKL in synovial fluid of RA patients[(7.68±5.41)ng/m,(296.93±254.48)pg/ml] was significantly higher than that of OA patients[(2.45±0.50)ng/m,(80.76±24.06)pg/ml](t=3.021,t=2.658;P<0.05).Conclusion:1.ANGPTL4 and RANKL were significantly higher in serum of patients with RA than in OA and healthy population,suggesting that both could act as proinflammatory factors and promote the process of immune inflammation in RA patients,thus promoting bone destruction and aggravating joint deformity.2.The differences of ANGPTL4 and RANKL between the different disease activities were statistically significant,and the two were positively correlated with ESR,CRP,joint swelling,joint tenderness,DAS28 score,age and course of disease.Promote the occurrence and development of RA patients,reflecting the disease activity.3.The expression levels of ANGPTL4 and RANKL in synovial fluid of RA patients was significantly higher than that of OA patients,suggesting that both of them could be used as proinflammatory factors in RA patients,wich may promote bone destruction and aggravate joint deformity. |
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