Mối tương quan giữa Ferritin và Transferrin với mức độ hoạt động ở bệnh nhân viêm khớp dạng thấp

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disorder characterized by systemic metabolic alterations, including disturbances in iron homeostasis; however, the clinical utility of ferritin and transferrin as biomarkers of disease activity remains uncertain. This study aimed to evaluate the value of serum ferritin and transferrin as indicators of disease activity and altered iron metabolism in patients with RA. A cross-sectional study was conducted involving 56 RA patients (fulfilling the ACR/EULAR 2010 criteria) and 56 age- and sex-matched healthy controls. Serum ferritin and transferrin were quantified using ECLIA and PETIA, respectively. Disease activity was assessed by DAS28-CRP, the Ritchie Articular Index, and the visual analogue scale (VAS). Laboratory evaluations included CRP, rheumatoid factor (RF), anti-CCP antibodies, hemoglobin, and serum iron. Correlation analyses and multivariate regression were performed to identify independent associations. Ferritin levels showed positive correlations with DAS28-CRP, CRP, RF, Ritchie Index, and VAS, whereas transferrin correlated negatively with CRP, DAS28-CRP, RF, and VAS, and positively with hemoglobin and serum iron (all p < 0.05). In multivariate models, CRP independently predicted elevated ferritin (β=2.606; p = 0.019) and reduced transferrin (β = −0.003; p = 0.006), while anti-CCP was independently inversely associated with ferritin (β = −0.975; p = 0.01). These findings demonstrate that ferritin and transferrin are strongly associated with inflammatory burden and disease activity, underscoring their potential as adjunctive biomarkers in the clinical assessment of RA.