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Objective To explore the clinical diagnostic value of serum dickkopf-1 (DKK1) level in menopausal women with rheumatoid arthritis (RA) secondary to osteoporosis (OP). Methods A total of 236 menopausal female patients diagnosed in the Second Affiliated Hospital of Nanchang University from May 2019 to September 2020 were collected, including 44 patients with OP secondary to RA set as RA+OP group, 150 patients with RA without OP set as RA group, and 42 patients with OP set as OP group, respectively. At the same time, 43 healthy menopausal women in our hospital at the same period were selected as control group. Serum DKK1 was detected by ELISA. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were detected by capillary method and rate-scattering turbidimetry, respectively; The bone metabolism indexes such as parathyroid hormone(PTH), type Ⅰ procollagen C-terminal propeptide (CTX), 25-hydroxy vitamin D3 [25-(OH)D3], type Ⅰ procollagen N-terminal propeptide (PINP) and osteocalcin were detected by electro-chemiluminescence method. While, bone alkaline phosphatase (BALP)was determined by chromatography; The bone mineral density (BMD), Z-score and T-score of total hip joint and lumbar spine L1-4 in all patients were detected by Lunar Prodigy dual energy X-ray absorptiometry. The area under the ROC curve was used to analyze the diagnostic efficacy of DKK1 in patients with RA combined with OP and those with RA or OP alone. Results DKK1, ESR, CRP, BMI, PTH, CTX, 25-(OH)D3, total hip BMD, total hip T-score, total hip Z-score, lumber spine L1-4 BMD, lumber spine L1-4 T score and lumber spine L1-4 Z score, CTX and BALP were significantly different among the 4 groups (P<0.01 or P<0.05); The difference of fracture story was statistically significant between RA+OP group and OP group (P<0.01). Bivariate correlation analysis conducted between DKK1 and each index showed that serum DKK1 was positively correlated with ESR, CRP, fracture story and BALP (P<0.05), and negatively correlated with BMI, total hip BMD, total hip T-score, total hip Z-score, lumber spine L1-4 BMD, lumber spine L1-4 T-score and lumber spine L1-4 Z-score, PINP, 25-(OH)D3 and PTH (P<0.01 or P<0.05). Multiple linear regression analysis showed that DKK1 was positively correlated with CRP and BMI (R2=0.048, β=0.034, P=0.003; and R2=0.008, β=0.178, P=0.042, respectively), and negatively correlated with PINP and total hip T-score (R2=0.003, β=–0.022, P=0.009; and R2=0.235, β=–2.375, P=0.000). ROC curve analysis showed that and the optimal cut-off value of DKK1 in the diagnosis of RA secondary to OP was 9.21 μg/L, the sensitivity was 93.2%, the specificity was 91.1%, and the Kappa consistency index was 0.630. The diagnostic efficiency of DKK1 for OP was higher than that of DKK1 for RA, and the Kappa consistency index was relatively stable. Conclusion The serum level of DKK1 is increased in menopausal women with RA secondary to OP, the detection of DKK1 has good diagnostic efficiency in the diagnosis of menopausal women with RA secondary to OP.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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