Background: It is known that rheumatoid arthritis (RA) can be a part of autoimmune polyglandular syndrome and be combined with endocrine diseases.
Objectives: To study the effects of autoimmune thyroiditis (AIT) and diabetes mellitus (DM) on the clinical and laboratory manifestations of RA.
Methods: The study included two groups of patients. The first group of patients included 24 patients (20 women and 4 men, mean age - 68.37±1.75 years) with a combination of RA and DM. The second group included 24 patients (20 women and 4 men, mean age - 59.1±2.13 years) with a combination of RA and AIT. In the group of patients with a combination of RA and DM 2 patients were with type 1 diabetes, 22 with type 2 diabetes. In a group of patients with RA and AIT 15 patients had euthyroidism, 8 had hypothyroidism, and 1 had hyperthyroidism. Patient groups were compared by statistical treatment and correlation analysis method for the following indices of rheumatoid arthritis: detection of rheumatoid factor in blood serum, presence of erosion on radiographs of the hands/feet, radiographic stage and on a scale of activity DAS-28.
Results: In both groups of patients similar data were obtained on the average results for the studied parameters (detection in the serum of the rheumatoid factor was noted in 75% and 87.5% of patients, erosion in 87.5% and 83% of patients, in 50% and 54% identified III X-ray stage of rheumatoid arthritis, a high degree of activity of rheumatoid arthritis was detected in 67% and 50% patients). However, using the Spearman correlation analysis in the first group of patients (combination of RA and DM), a direct relationship between the presence of erosion and the degree of activity of rheumatoid arthritis (DAS-28, R=0.39, P<0.05), as well as between the detection of rheumatoid factor in the blood and the degree of disease activity (R=−0.63, P<0.05). In the second group of patients (a combination of RA and AIT), a direct relationship was found between the detection of rheumatoid factor and the degree of disease activity (R=0.39, P<0.05).
Conclusions: Thus, in the first group of patients there is a stronger correlation between the clinical and laboratory indicators of RA, including the severity of bone destruction, than in patients with a combination of RA and AIT. This fact can speak about synergistic enhancement of damage to the joint tissue pathogenetic mechanisms inherent in both diabetes and RA.
18 - 21 May 2019
European Society of Endocrinology