Correlation between DAS28 and Serum Hepcidin Levels in Patients with Anemia and Rheumatoid Arthritis

AIM Anemia in rheumatoid arthritis (RA) is related to the chronic inflammatory nature of the disease. It occurs as iron deficiency, mostly due to drug-induced gastrointestinal bleeding and disorders as well as iron redistribution into inflamed joint structure. We tried to find a correlation between disease activity score (DAS28) and serum hepcidin levels in order to identify and find the right treatment approach for iron deficiency in patients with anemia of chronic disease. DATA We determined serum hepcidin levels using ELISA assay in patients with rheumatoid arthritis. Number of patients included 50. They were diagnosed with RA in the University Hospital St. Ivan Rilski, Clinic of Rheumatology for a period 2013 2014 year. Activity of the disease was determined by DAS 28 for RA. Patients were divided into three groups RA without anemia, RA with iron deficiency anemia (IDA) and RA with ACD. RESULTS We found statistically significant differences in serum hepcidin levels between measured groups RA without anemia 14.9 7.6 g/L, RA with IDA - 0.7 0.3 g/L, RA with ACD 88.0 9.7 g/L. We found a significant negative correlation between serum hepcidin levels and DAS28 in patients with RA without anemia (r = -0.834, P less than 0.05), and significant positive correlation between serum hepcidin levels and DAS28 in patients with RA with ACD (r = 0.679, P less than 0.001). CONCLUSIONS We conclude that our results may support the right choice of a therapeutic approach to the iron-deficiency anemia or anemia of chronic inflammation in rheumatoid arthritis.