Estimation of the role of growth differentiation factor‑15 and atherogenic indices as predictors of disease severity in Iraqi patients with rheumatoid arthritis (Middle Euphrates Region)
DOI:
https://doi.org/10.12923/cipms-2026-0004Słowa kluczowe:
rheumatoid arthritis, growth differentiation factor‑15 (GDF-15), disease activity, biomarkers, lipid profile, C‑reactive protein, disease activity score‑28, erythrocyte sedimentation rateAbstrakt
Rheumatoid arthritis (RA) is a chronic immune‑mediated disease characterized by persistent inflammation, edema, and joint pain. Growth differentiation factor 15 (GDF-15) is a cytokine whose concentration increases in chronic inflammatory states. It has been recognized as both a pro-inflammatory mediator and a potential contributor to the development of cardiovascular disease due to its association with systemic inflammation and metabolic disorders. The aim of this study was to evaluate serum GDF‑15 levels and atherogenic indices as predictors of disease activity in patients with RA. A total of 150 RA patients and 150 healthy controls were included. Serum concentrations of GDF‑15, rheumatoid factor (RF), C‑reactive protein (CRP), and anti‑citrullinated protein antibodies (ACPA) were measured using ELISA. Lipid parameters, including total cholesterol, triglycerides (TG), and HDL‑C, were assessed spectrophotometrically. Based on the DAS28‑CRP calculator, RA patients were classified into high disease activity (HDA; DAS28‑CRP > 5.1) and moderate disease activity (MDA) groups. Multivariate general linear model (GLM) analysis and Receiver Operating Characteristic (ROC) curve assessment were performed to identify predictors of RA activity. The results indicated that RA status explained 92.1% of the variance in the measured serum biomarkers. GDF‑15 was identified as the most sensitive predictor of elevated disease activity, followed by the atherogenic indices CRI‑I, AC, and AIP. Patients in the HDA group demonstrated significantly higher levels of GDF‑15, CRP, ESR, and ACPA compared with those in the MDA group. GDF‑15 exhibited a strong positive correlation with key inflammatory markers, including ESR and CRP. These findings suggest that GDF‑15, CRI‑I, AC, and AIP are the most sensitive predictors associated with increased RA activity. The combined use of GDF‑15 and atherogenic indices yielded the largest area under the ROC curve, indicating their potential value in assessing RA severity. Moreover, RA patients showed elevated cholesterol levels and adverse atherogenic profiles, placing them at heightened risk for cardiovascular diseases linked to atherosclerosis.
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Prawa autorskie (c) 2026 Ghufran Abd Omran Abdulridha, Mustafa Abdulkadhim Hussein, Suhad Rasheed Majeed (Autor)
Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne – Bez utworów zależnych 4.0 Międzynarodowe.
