Correlation Of STIM-3/Gal-9 Signal Axis Expression With Rheumatoid Arthritis Disease Activity And Osteoporosis

Objective:To investigate the correlation of s TIM-3 / Gal-9 signal axis expression with rheumatoid arthritis disease activity and osteoporosis for finding new serological markers to predict RA disease activity and complications.Methods:A total of 120 patients with rheumatoid arthritis who met the inclusion and exclusion criteria were selected and divided into 4 groups according to DAS28 score:Disease remission group(DAS28<2.6 points)、 low disease activity group(2.6points≤DAS28≤3.2points)、Moderate disease activity group(3.2 points <DAS28≤5.1points)、Higher disease activity group(DAS28>5.1 points);According to the results of bone mineral density,they were divided into 3 groups: normal bone mass group、reduced bone mass group and osteoporosis group.Healthy control group 32 cases.After obtaining the consent of the subjects,5ml of fasting cubital vein blood was taken,and the upper serum was taken after centrifugation and stored in the-80 °refrigerator for future use.Baseline data of all subjects were collected,including gender,age,course of disease,number of joint swelling and pain,etc.Collect laboratory indexes including rheumatoid factor(RF),citrulline resistance protein(CCP)antibody,blood sedimentation(ESR),c-reactive protein(CRP)and interleukin6(IL 6)and white blood cell count(WBC),red blood cell count(RBC),hemoglobin(Hb)and platelets(PLT),alanine aminotransferase(ALT),aspertate aminotransferase(AST),serum creatinine(SCr),urea nitrogen(BUN);Total T value and total Z value of hip joint and lumbar spine were collected.The expression levels of Gal-9,STIM-3and TNF-α in the samples were determined by ELISA.Analysis of differences between baseline data and basic laboratory indicators;The expressions of GAL-9,STIM-3,IL-6,RF,anti-CCP antibody,ESR and CRP in each group were compared.Spearman correlation coefficient was used to analyze the correlation between GAL-9and STIM-3 and RF,anti-CCP antibody,ESR,CRP,IL-6,TNFα and DS-28 scores in specific groups.Receiver operating characteristic curve(ROC)was used to calculate the area under the curve(AUC)to evaluate the predictive value of STIM-3 for RA disease activity.Results:(1)In the evaluation of RA disease activity,the expression of STIM-3 in serum of RA patients was higher than that of healthy controls,and increased with the aggravation of disease activity,the difference was statistically significant(F =52.972,P<0.05).On the contrary,the expression level of GAL-9 in the experimental group decreased with the aggravation of disease activity.The differences were statistically significant(H =74.733,P<0.05).(2)In the evaluation of osteoporosis,the expression level of STIM-3 in osteoporosis group > osteopenia group > normal bone mass group was significant at 0.01 level(F=10.306,P =0.000),and the expression level of GAL-9in osteoporosis group was lower than that in osteopenia group and normal bone mass group.It was significant at 0.01 level(F=8.627,P =0.000).(3)Correlation analysis showed that STIM-3 was positively correlated with DASS-28 score(r=0.616**,P<0.01),ESR(r =0.551**,P<0.01),CRP(r =0.531**,P<0.01),TNF-α(r=0.559**,P<0.01),All were positively correlated;Gal-9 was negatively correlated with DASS-28 score(r=-0.705**,P<0.01),ESR(r=0.676**,P<0.01),CRP(r=0.620**,P<0.01),TNF-α(r=0.544**,P<0.01).(4)The receiver operating characteristic curve(ROC)was drawn and the area under the curve(AUC)was calculated using STIM-3,CRP and ESR.The AUC of STIM-3 was 0.899,which was slightly lower than the AUC of CRP and ESR,which was 0.960 and 0.939.It means that the expression of s TIM3 in RA serum has a good predictive value for RA disease activity.Conclusions:1.The expression of s TIM-3 was positively correlated with RA disease activity,and Gal-9 was negatively correlated with RA disease activity,both may become new serological indicators for assessing RA disease activity.2.The increase of s TIM-3 and the decrease of Gal-9 have certain reference significance in evaluating RA with osteoporosis.