High Plasma Homocysteine Level and Rheumatoid Arthritis (RA)
Overview
Title: High plasma homocysteine level is associated with increased prevalence of the non-remission state in rheumatoid arthritis
Source: Modern Rheumatology, Oxford Academic
Published: September 7, 2022
Objectives
To determine the impact of plasma homocysteine levels on disease activity and remission in RA patients.
Methods
Type of Study: Cross-sectional study
Data Source: KURAMA (Kyoto University Rheumatoid Arthritis Management Alliance) database
Participants: 291 female RA patients treated in a treat-to-target manner
Measurements: Plasma total homocysteine using liquid chromatography-tandem mass spectrometry and DAS28-ESR scores
Key Terms
DAS28-ESR: A measure of RA disease activity (Erythrocyte Sedimentation Rate)
Non-remission state: Defined as DAS28-ESR ≥ 2.6
Results
Association: A significant positive association between plasma homocysteine levels and DAS28-ESR scores.
Non-remission Prevalence: Higher plasma homocysteine levels in non-remission group compared to remission group.
Cut-off Value: Plasma homocysteine level cutoff calculated at 7.9 nmol/mL via ROC curve analysis.
Multivariable Analysis: High homocysteine remains a significant factor for higher DAS28-ESR (estimate 0.27, P = .0019) and non-remission state (odds ratio 2.39, P = .0071).
Conclusions
Elevated plasma homocysteine levels are significantly associated with increased disease activity and non-remission in RA.
Potential use of plasma homocysteine as a marker for disease state and treatment outcomes.
Findings suggest a link between homocysteine levels and inflammatory activity in RA.
Study Implications
Plasma homocysteine could be used as a biomarker for identifying RA patients at risk of non-remission.
May provide insights into treatment strategies for RA management, particularly in females.