AB0079 ANGIOPOETIN-LIKE PROTEIN TYPE 3 AS AN INDICATOR OF RHEUMATOID INFLAMMATION AND RESORPTION OF BONE TISSUE IN RHEUMATOID ARTHRITIS

Abstract

Objectives: to study the role of type 3 angiopoietin-like protein (ANGPTL3) in the development of osteoporotic processes associated with inflammation in rheumatoid arthritis (RA). Methods: 88 patients with RA were examined (women-100%, average age-54.2 ± 12 years old, disease duration-11.2 ± 8.7 years, positive for rheumatoid factor (RF-IgM)-72.7%, positive for anti-citrullinated protein antibody (ACPA)-67%), DAS28 activity: remission-21.6%, minimal-11.4%, medium-59.1%, high-7.9%.), functional class: 0-1.1%, I-25%, II-65.9%, III-8%). The study was conducted on a bone X-ray densitometer LUNAR DPX (GE, USA). Most of the patients (96.6%) were residents of cities, and 67 (76.1%) people lived in the metropolis (number of inhabitants more than 1 million people). The concentration of ANGPTL3 in serum was determined by enzyme immunoassay using a commercial test system “Human Angiopoietin-like Protein 3 ELISA” (“Bio Vendor”). Results: Osteoporosis is found in 52 (59%) people. Increased ANGPTL3 values (> 445 ng / ml) were determined in 80.7% of cases. A significant positive correlation was found between the level of ANGPTL3 and the age of patients (r = 0.23, p = 0.032), the functional class (r = 0.214, p = 0.046), the presence of osteoporosis (r = 0.36, p = 0.039), living in the metropolis (r = 0.214, p = 0.046) and smoking (r = 0.31, p = 0.036), as well as a negative relationship with the duration of walking per day (r =-0.314, p = 0.003) and weekly (r =-0.319, p = 0.002) was determined. The level of ANGPTL3 correlated with the activity of RA calculated by the DAS28-CRP index (p = 0.037), but not by the DAS28-ESR index (p = 0.135). It is noteworthy that ANGPTL3 is closely related to changes in bone mineral density (BMD) in the femoral neck (BMD Total: r =-0.33, p = 0.042; BMD Troch: r =-0.36, p = 0.038; BMD Wards: r =-0.44, p = 0.009), but not in the spine (L1-L4) (p> 0.05). The lack of connection of ANGPTL3 with ACPA (p = 0.128) may indicate different mechanisms of influence on systemic BMD in patients with established RA. Conclusion: ANGPTL3 can be used as an indicator of pathological processes associated with rheumatoid inflammation and the development of osteoporosis. Living in a metropolis, smoking and low physical exertion has an additional negative effect on resorptive processes in bone tissue in women with active RA.