Clinical Rheumatology最新文献

{"title":"Interplay of calcium pyrophosphate crystals, oxidative stress, and clinical features on knee osteoarthritis severity.","authors":"Javier Fernández-Torres, Karina Martínez-Flores, Indira Xiomara Puerta-Escalante, Nathalie Montaño-Armendariz, Carlos Suárez-Ahedo, Víctor Ilizaliturri-Sánchez, Rolando Espinosa-Morales, Carlos Alberto Lozada-Pérez, Yessica Zamudio-Cuevas","doi":"10.1007/s10067-024-07220-y","DOIUrl":"10.1007/s10067-024-07220-y","url":null,"abstract":"<p><strong>Background: </strong>Deposition of calcium pyrophosphate (CPP) crystals is observed in most joints affected by severe osteoarthritis (OA). CPP may cause local damage by inducing an inflammatory process and oxidative stress (OS).</p><p><strong>Objectives: </strong>To evaluate inflammation and OS induced by CPP deposition and their association with the degree of knee OA.</p><p><strong>Methods: </strong>Synovial fluid (SF) from patients with OA classified as grade 3 and 4 (ACR criteria) was analyzed. Reactive oxygen species (ROS) and H₂O₂ levels were quantified, and inflammation by white blood cell (WBC) count. CPPs were detected by polarized light microscopy. Multifactorial dimensionality reduction (MDR) was used to visualize possible interactive effects between variables.</p><p><strong>Results: </strong>Fifty-six SF were analyzed, 22 (39.28%) were in moderate OA and 34 (60.71%) in severe OA. CPPs were identified in 17 moderate OA and 18 severe OA samples. In the moderate OA, ROS levels were significantly higher in the CPP + group (5.0% vs 2.0%, P = 0.03). Body mass index and CPP were significantly correlated (r =  - 0.439, P = 0.041). In the severe OA group, there were significant correlations of age with WBC (r =  - 0.431, P = 0.011), WBC with H₂O₂ (r = 0.454, P = 0.007), and ROS with H₂O₂ (r = 0.387, P = 0.024). MDR analysis revealed strong synergistic interactions between H₂O₂ and sex (6.68%) for moderate OA, while for severe OA, there were interactions between sex and ROS (6.99%) and between sex and inflammation (4.39%).</p><p><strong>Conclusion: </strong>ROS and inflammation may be factors that potentiate damage in knee OA, and this may help in the development of antioxidant interventions for CPP-associated OA. Key Points • This study evaluated CPP crystal-induced oxidative stress and inflammation and their effect on OA severity. • In the moderate OA phenotype, CPP crystals modify ROS levels. • ROS and inflammation are factors that increase damage in knee OA, especially when CPP crystals are present.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"433-441"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction model for bone erosion in rheumatoid arthritis based on musculoskeletal ultrasound and clinical risk factors.","authors":"Lei Yan, Minghang Lin, Xiaojian Ye, Wenting Li, Jing Xu, Yabin Fang, Shuqiang Chen","doi":"10.1007/s10067-024-07219-5","DOIUrl":"10.1007/s10067-024-07219-5","url":null,"abstract":"<p><strong>Purpose: </strong>Progressive bone erosion (BE) is a prominent manifestation of structural damage in rheumatoid arthritis (RA). This study aimed to construct and validate a BE prediction model (BEPM) for RA based on musculoskeletal ultrasound and clinical risk factors.</p><p><strong>Methods: </strong>A total of 312 RA patients without BE were consecutively collected and followed up for 2 years, who were divided into BE group and non-bone erosion group, as confirmed by two radiology experts based on at least two imaging techniques. Relevant clinical information, such as anti-cyclic citrullinated peptide (ACCP) antibody and disease duration, was collected. Musculoskeletal ultrasound examinations were performed on all patients upon admission. Univariate and binary logistic regression analyses were conducted to identify risk factors for BE and to establish the prediction model. The calibration, diagnostic efficacy, and clinical effectiveness of BEPM were evaluated by calibration curve plots, receiver-operating characteristic curve, and decision curve analysis (DCA).</p><p><strong>Results: </strong>Binary logistic regression analysis screened four variables, including synovial hyperplasia, synovial blood flow, ACCP + , and disease duration, into the prediction model. BEPM exhibited good diagnostic performance in both the training and validation groups, with area under the curve values of 0.949 (95% CI 0.924-0.973) and 0.965 (95% CI 0.935-0.996), respectively. Using 0.376 as the optical cutoff value for BE, the sensitivity, specificity, and Youden index of the model in the training group were 86.0%, 90.4%, and 76.4%, respectively. In the DCA curves, BEPM indicated overall good population benefit.</p><p><strong>Conclusion: </strong>BEPM demonstrates high diagnostic performance and clinical utility, and may be a useful clinical model for predicting BE in patients with RA. Key Points • Synovial hyperplasia, synovial blood flow, ACCP+ , and disease duration are independent risk factors for bone erosion in RA patients. • BEPM exhibits good diagnostic performance in both the training and validation groups. • Combining musculoskeletal ultrasound parameters with key clinical risk factors to construct a bone erosion model is feasible.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"143-152"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction model for psoriatic arthritis: NHANES data and multi-algorithm approach.","authors":"Jinshan Zhan, Fangqi Chen, Yanqiu Li, Changzheng Huang","doi":"10.1007/s10067-024-07244-4","DOIUrl":"10.1007/s10067-024-07244-4","url":null,"abstract":"<p><strong>Objective: </strong>To develop a simplified predictive model for identifying psoriatic arthritis (PsA) in psoriasis patients.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey (NHANES) database were analyzed, including patients with psoriasis without arthritis (PsC) or PsA. The least absolute shrinkage and selection operator, Boruta algorithm, random forest, and stepwise regression were employed to select key variables from 38 potential predictors. Logistic regression models were constructed for each combination of selected variables and evaluated using receiver operating characteristic (ROC) curves, precision-recall (PR) curves, calibration plots, Brier scores, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The study included 587 patients with psoriasis, 238 of whom had PsA. The variable combinations proposed by the Boruta algorithm exhibited the best overall performance. Key predictors in the Borutamodel included age, fasting glucose, education level, thyroid disease, hypertension, and chronic bronchitis. This model achieved area under the curve (AUC) of 0.781 (95% CI, 0.737-0.826) for the training set and 0.780 (95% CI, 0.712-0.848) for the testing set in the ROC curve analyses. The AUC values in the PR curves were 0.687 (95% CI, 0.611-0.757) and 0.653 (95% CI, 0.535-0.770), respectively. The Brier scores of 0.186 and 0.191 for the testing and training sets indicated a good fit, further supported by the calibration curves. DCA showed a net clinical benefit for decision thresholds ranging from 0.2 to 0.8 in both datasets.</p><p><strong>Conclusion: </strong>The Borutamodel represents a promising tool for early risk assessment of PsA. Key Points • National Database Utilization: This study leverages the NHANES database to predict psoriatic arthritis risk, addressing previous limitations tied to regional or ethnic constraints. • Comprehensive Variable Analyses: The research examines 38 variables, including demographics, health conditions, laboratory results, and lifestyle factors, using four distinct screening methods and thorough evaluations of model performance. • Innovative Risk Model: The study introduces a novel risk assessment model that integrates age, fasting glucose, education, and comorbidities including hypertension, thyroid disease, and chronic bronchitis, thus moving beyond traditional focus on skin lesions and joint symptoms.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"277-289"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty in older adults with systemic lupus erythematosus and emergency department utilization: an administrative claims data analysis of Medicare beneficiaries.","authors":"Sarah B Lieber, Musarrat Nahid, Iris Navarro-Millán, Mangala Rajan, Sebastian E Sattui, M Carrington Reid, Lisa A Mandl","doi":"10.1007/s10067-024-07173-2","DOIUrl":"https://doi.org/10.1007/s10067-024-07173-2","url":null,"abstract":"<p><strong>Introduction / objectives: </strong>While presence of concomitant SLE and frailty has been associated with greater emergency department (ED) use than SLE alone in young/mid-aged adults, whether frailty increases ED use in older adults with SLE remains unknown. In a nationally representative United States administrative claims dataset, we investigated the association of frailty duration with use of ED services in the SLE population compared with individuals without systemic rheumatic disease (SRD).</p><p><strong>Method: </strong>We identified Medicare beneficiaries ≥ 65 years with SLE and matched them (1:4) by age and gender with non-SRD comparators with osteoarthritis. Frailty was determined using a claims-based index and examined each study year (1/2006-9/2015). We used mixed-effect Poisson regression to ascertain the effect of frailty duration exposure on the risk of ED visits in those with SLE and in non-SRD participants, adjusting for covariates.</p><p><strong>Results: </strong>At baseline (2006), frailty prevalence was similar in participants with SLE (N = 1338; 43.7%) and no SRD (N = 5352; 42.4%) (p = 0.37). Frailty prevalence significantly increased and diverged over time between participants with SLE versus no SRD (67.6% versus 63.7% in 2010 and 83.5% versus 78.1% in 2014) (p < 0.05). As frailty duration increased, risk of ED visits increased in both groups, including after covariate adjustment (SLE: incidence rate ratio [IRR] 1.10, 95% confidence interval [CI] 1.09-1.12; non-SRD: IRR 1.09, 95% CI 1.08-1.10).</p><p><strong>Conclusions: </strong>In this cohort of older adults, duration of frailty conferred similar increased risk of ED visits among those with and without SLE. This underscores the importance of measuring frailty in older populations with SLE. Key Points • Frailty prevalence was similar at baseline, and increased over time, in participants with SLE and those with no systemic rheumatic disease; however, frailty prevalence increased to a greater extent in those with SLE. • Frailty duration conferred similar increased risk of ED visits among older adults with and without SLE. • This underscores the importance of identifying, preventing, and/or reversing frailty in older populations with SLE and not assuming that SLE alone adequately explains health risks.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-onset axial spondyloarthritis: data from Reuma-check cohort.","authors":"Rodrigo Garcia-Salinas, Gisel Reyes-Jara, Felicia Almada, Santiago Ruta, Sofia Ramiro","doi":"10.1007/s10067-024-07299-3","DOIUrl":"https://doi.org/10.1007/s10067-024-07299-3","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the prevalence of late-onset axial spondyloarthritis (lo-axSpA) and to identify clinical, laboratory, and imaging features associated with this phenotype.</p><p><strong>Methods: </strong>This single-center, observational study included patients diagnosed with axSpA from the \"Reuma-check\" SpA program. Patients with a symptom onset ≥ 45 years were classified as lo-axSpA, as opposed to early-onset axSpA (eo-axSpA, onset < 45 years). The prevalence of lo-axSpA was calculated, and lo-axSpA and eo-axSpA were compared in terms of clinical, laboratory and imaging characteristics. Factors associated with lo-axSpA were analyzed with univariable followed by multivariable logistic regression.</p><p><strong>Results: </strong>A total of 126 patients were included, 35 (28%) were lo-axSpA. Comparing lo-axSpA vs. eo-axSpA, significant differences were observed: higher female prevalence in lo-axSpA vs. eo-axSpA (51% vs. 29%), lower NSAID response (52% vs. 73%), increased skin psoriasis prevalence (42% vs. 17%,), and shorter diagnosis delay (40 vs. 93 months). In the multivariable analysis, male sex and diagnosis delay were independently and inversely associated with lo-axSpA (OR 0.2, 95% CI 0.06-0.8 and OR 0.9, 95% CI 0.96-0.99, respectively), while psoriasis was associated with a higher odds for lo-axSpA (OR 4.8, 95% CI 1.1-29).</p><p><strong>Conclusion: </strong>lo-axSpA was present in more than a quarter of the patients. Although recall bias in the symptom duration cannot be excluded, the presentation with lo-axSpA seems to be associated with distinct features, being more frequent in females and more associated with psoriasis and with a shorter diagnostic delay. Key Points • Late-onset axSpA (≥ 45Y) is observed in 28% in our cohort, a higher frequency than previously reported. • Female sex and psoriasis are associated with a higher likelihood for late-onset axSpA.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical overview of systematic reviews and meta-analyses of intra-articular injection of platelet rich plasma versus hyaluronic acid for knee osteoarthritis.","authors":"Qinxin Zhou, Jixin Chen, Weijie Yu, Dongdong Cao, Yuntian Ye, Jianzeng Shen","doi":"10.1007/s10067-024-07264-0","DOIUrl":"https://doi.org/10.1007/s10067-024-07264-0","url":null,"abstract":"<p><p>This study is to summarize and evaluate the available evidence for the efficacy of platelet-rich plasma (PRP) and hyaluronic acid (HA) for knee osteoarthritis (KOA). Eight databases were searched from inception to September 15, 2024. All systematic reviews (SRs)/meta-analyses (MAs) treated with PRP versus HA for KOA were collected. Literature screening and data extraction were independently performed by two reviewers. The methodological quality, reporting quality, risk of bias, evidence quality, and evidence overlap rate of the included studies were evaluated by using AMSTAR 2, PRISMA 2020, ROBIS, GRADE, and GROOVE systems. Seventeen SRs were included. The results showed that the effectiveness and safety of PRP in the treatment of KOA may be superior to HA. The methodological quality of all 17 documents was extremely low quality. Sixteen of them had poor reporting quality, and there were relatively serious information deficiencies. All SRs were determined to be at high risk. Among the 221 outcome indicators, there were two medium-quality evidences, 30 low-quality evidences, and 189 extremely low-quality evidences. It was found that there was a very high overlap among the included articles. Currently, the quality of SRs on the treatment of KOA with PRP versus HA is relatively low. Future authors of SRs should adhere to quality assessment tool criteria, expand sample sizes to reduce overlap, and evaluate the quality of evidence for merged study results, in order to provide more reliable and rigorous evidence-based support for clinical practice.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal association between bone mineral density and the risk of joint replacement in patients with osteoarthritis: a Mendelian randomization study.","authors":"Rui Zhu, Xing Xing, Jingyuan Bian, Xiaoyue Zhang, Liru Ge, Guoqi Cai","doi":"10.1007/s10067-024-07289-5","DOIUrl":"https://doi.org/10.1007/s10067-024-07289-5","url":null,"abstract":"<p><p>Population-based studies have been inconsistent in terms of the relationship between bone mineral density (BMD) and the progression of osteoarthritis. This study aimed to evaluate the causal relationship between BMD and the risk of joint replacement in patients with osteoarthritis. We performed a two-sample Mendelian randomization (MR) analysis to determine the association of BMD of the total body, femoral neck, and lumbar spine with the risk of hip and knee replacements. Inverse variance weighting (IVW) was used as the main analysis method. Heterogeneity and horizontal pleiotropy were checked. Multivariable MR analysis was performed by adjusting for hip/knee pain, body mass index (BMI), estrogen levels, BMI-based sex hormone-binding globulin (SHBG) levels, and physical activity. BMD of the total body and the lumbar spine were significantly associated with higher risks of both knee (IVW odds ratios (ORs) = 1.08-1.10, p = 4.62E-03) and hip replacements (IVW ORs = 1.19-1.37, P = 3.23E-09). Femoral neck BMD was significantly associated with the risk of hip but not knee replacement (IVW OR = 1.27, 95% confidence interval 1.13 to 1.43, p = 9.15E-05). Multivariable MR analyses produced similar results compared to the univariable analyses. No evidence of heterogeneity and horizontal pleiotropy were found, except that there was heterogeneity in the association between total body BMD and the risk of knee replacement. BMD is significantly associated with an increased risk of both knee and hip replacement, and the association is stronger for hip replacement. These findings suggest a causal relationship between BMD and the progression of osteoarthritis. Key Points • BMD is associated with an increased risk of hip and knee joint replacement. • BMD was more strongly associated with hip replacement risk.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary albumin-to-creatinine ratio for predicting risk of all-cause mortality and specific-cause mortality in patients with rheumatoid arthritis: evidence from NHANES 1999-2018.","authors":"Mengshi Tang, Leilei Du, Jia Peng","doi":"10.1007/s10067-024-07272-0","DOIUrl":"https://doi.org/10.1007/s10067-024-07272-0","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relationship between urinary albumin-to-creatinine ratio (uACR) and all-cause/specific-cause mortality among patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>This study included 1354 RA patients in the National Health and Nutritional Examination Surveys (NHANESs) during 1999-2018. The mortality status was assessed by linkage to death certificate data reported in the National Death Index (NDI) until December 31, 2019. Cox proportional hazards models and Kaplan-Meier (K-M) analysis were used to elucidate the relationship between uACR and all-cause/specific-cause mortality. Restricted cubic spline (RCS) was used to visualize the association of uACR with all-cause mortality risk. Stratified analyses were employed to identify patients with higher mortality risk.</p><p><strong>Results: </strong>Over a median of 115 months of follow-up, 298 deaths occurred. Cox proportional hazards models indicated that RA patients with higher uACR had an increased risk of all-cause mortality, but not cardiovascular disease, kidney disease, and cancer mortality. K-M survival curves showed a significant difference (log-rank, p < 0.001) in all-cause mortality among uACR tertiles. RCS analysis revealed an L-shaped association between uACR and all-cause mortality, and patients with uACR above the threshold points (5.96 mg/g) had a 13.2% increased risk of all-cause mortality (HRs 1.132; 95% CI 1.011, 1.267) for each ln unit increase in uACR. The stratified analysis revealed consistent patterns for correlations between uACR and all-cause mortality.</p><p><strong>Conclusions: </strong>High uACR, even in the normal range, was associated with an increased risk of all-cause mortality (not specific-cause mortality) in individuals with RA. Identifying high-risk populations using uACR assessment may contribute to target risk interventions among RA patients in the future. Key points • uACR, even within the normal range, significantly increased the hazard for all-cause mortality among RA patients. • uACR has good performance in identifying populations with different mortality risk levels in RA patients. • uACR, independent of varied well-recognized cardiovascular risk factors, is a predictor of mortality in RA patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of predictive factors influencing rheumatoid arthritis associated with interstitial lung disease.","authors":"Wenyi Zhou, Yeying Yang, Li Su","doi":"10.1007/s10067-024-07282-y","DOIUrl":"https://doi.org/10.1007/s10067-024-07282-y","url":null,"abstract":"<p><strong>Objective: </strong>This study is aimed at identifying key risk factors associated with the onset of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) and developing and validating a novel risk prediction model for RA-ILD.</p><p><strong>Methods: </strong>This is a hospital-based retrospective cohort study. A total of 459 RA patients were selected from Longhua Hospital Affiliated with Shanghai University of Traditional Chinese Medicine between 2015 and 2020 as observation subjects. Demographic and clinical data were collected through the hospital's medical record system. The analysis involved evaluating demographic factors, joint clinical characteristics, traditional Chinese medicine (TCM) syndrome classification, laboratory indicators, medication history, and their associations with RA-ILD. Subsequently, a machine learning model was applied to create and validate a novel risk prediction model for the onset of RA-ILD.</p><p><strong>Results: </strong>The overall frequency of RA-ILD was 42.70%. Advanced age, smoking, elevated rheumatoid DAS28 score, higher radiographic joint staging (Phases II and III), strong positive CCP status (above 200), and methotrexate therapy were identified as independent risk factors for RA-ILD. Conversely, hormone therapy was found to be a protective factor against RA-ILD development. The RA-ILD prediction model, formulated based on these risk factors, exhibited superior predictive performance compared to existing models, with an AUC of 0.8914 (95% CI 0.8593-0.9234), a sensitivity of 74.5%, and a specificity of 89.7%.</p><p><strong>Conclusion: </strong>The study results highlighted the risk factors for the onset of RA-ILD and underscored the utility of the established RA-ILD nomogram model for early identification of RA-ILD patients and predicting the future risk of RA-ILD in individuals with rheumatoid arthritis.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of vitamins D, B12, C, and K in modulating inflammation and disease management in rheumatoid arthritis: a comprehensive review.","authors":"Nawal Hijjawi, Faten S Tout, Baraah Azaizeh, Baraah Aljaafreh","doi":"10.1007/s10067-024-07285-9","DOIUrl":"https://doi.org/10.1007/s10067-024-07285-9","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disorder marked by joint inflammation and destruction. Recent studies emphasize the importance of vitamins D, B12, C, and K in managing RA and enhancing patient health. Vitamin D deficiency is common in RA patients and correlates with increased disease severity, indicating its potential to modulate immune responses and reduce inflammation. Supplementation has shown promise in improving disease activity scores and lowering inflammatory markers. Vitamin B12 is vital for energy and neurological function; its deficiency can worsen fatigue in RA sufferers. Vitamin C, with its antioxidant properties, aids collagen synthesis and may reduce joint inflammation. Vitamin K, particularly through Matrix Gla-Protein (MGP), is essential for bone health and may help prevent joint calcification and osteoporosis. Collectively, these vitamins play critical roles in immune modulation, inflammation reduction, and bone health in RA management, warranting further research on optimal dosages and combinations for effective treatment strategies.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}