Hepatic Biomarkers Signatures and Systemic Hematological Indices in patients with Rheumatoid Arthritis

BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune, chronic inflammatory disorder with systemic effects that can impact liver function, inflammatory parameters, and hematological parameters other than those relating to joints. AIMS OF THE STUDY: The present study was designed to assess the levels of liver function tests, inflammatory markers, and hematological parameters in RA patients and to explore their correlation with age and gender differences. MATERIALS AND METHODS: This case–control study comprised 50 RA patients and 30 apparently healthy age- and sex-matched controls. Standard laboratory procedures were used to measure biochemical, inflammatory, and hematological markers. Data analysis was carried out with parametric, principal component analysis, hierarchical clustering, and correlation mapping and a P < 0.05 level of significance was set. RESULTS: RA patients exhibited significantly elevated total bilirubin (0.91 ± 0.42 vs. 0.68 ± 0.09 mg/dL), alkaline phosphatase (ALP) (107.80 ± 18.95 vs. 89.03 ± 4.60 U/L), C-reactive protein (28.58 ± 33.04 vs. 1.97 ± 0.85 mg/L), erythrocyte sedimentation rate (31.28 ± 9.62 vs. 6.03 ± 1.25 mm/L), platelet count, and white blood cell count compared with controls ( P < 0.05). This was seen to be significantly different across the age groups for the markers ALP, alanine aminotransferase, aspartate aminotransferase, lymphocyte percentage (%), neutrophil-to-lymphocyte ratio, and bilirubin. Male and female patients had a significant elevation of inflammatory indices and selected hepatic parameters as compared to their respective controls, whereas a few of the hematological indices were not statistically different. CONCLUSIONS: These changes suggest inflammatory activation in RA and mild changes in the liver; the latter seem to be mainly inflammatory in nature and not due to direct damage to the hepatocytes. Routine blood liver function testing and inflammatory marker levels could be useful for assessing disease activity and systemic complications in patients with RA.