The relationship between Serum Copper and some prognostic objective variables in patients with Rheumatoid Arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a progressive inflammatory disease, which could result in significant morbidity and mortality. Early and  aggressive  intervention  with  a  new  and  effective  biological treatment can alter the course of the disease, lengthen life, and improve function. Besides the rheumatoid factor (RF), another group of auto antibody has recently been detected in serum of patients with RA; the anti-cyclic citrullinated peptide antibodies (ACPA) which considered as a predictive of erosive disease with bad prognosis, in addition there are a number of prognostic variables that predict a poor outcome have been identified. Many studies found variable results regarding serum copper (S.Cu) levels in RA patients.
Objective: To assess the relationship between serum copper and some prognostic variables in rheumatoid arthritis.  
Methodology: This study was a cross sectional study implemented in the  Rzgary  general  teaching  hospital  in  Erbil  governorate-Kurdistan region/Iraq through the period of 12 months from 1st of November 2019, to 1st of November 2020. Study sample included fifty patients with RA. The diagnosis of RA was done according to 2010-American College of Rheumatology-European League against Rheumatism criteria. The S.Cu of patients was assessed in regard to variables of RA in the studied patients. 
Results: There were a significant association between previous history of Cu wearing and high S.Cu level of RA patients (p=0.01), longer RA disease duration and high serum Cooper level (p<0.001), In addition, the positive ACPA, rheumatoid nodule and morning stiffness of patients were  significantly  related  to  high  S.Cu  level  (p<0.001,  p=0.001, p<0.001,  respectively.  There  were  a  highly  significant  association between presence of bone erosions in x-ray of hand   and high S.Cu level (p<0.001),  anemia  (p<0.001),  high  ESR  level  (p<0.001).  While  no significant differences were observed between S.Cu level regarding age (p=0.4), gender (p=0.1) and RF (p=0.75). 
Conclusions: The serum copper level in rheumatoid arthritis patients was significantly related with many variables which considered as a predictor for disease prognosis. Encouraging physicians to adopt the serum copper level in assessment and monitoring of patients with rheumatoid arthritis.