Association of Osteopontin, Interleukin10 and Interleukin17 Levels with Liver Function Tests in Sudanese Patients with Rheumatoid Arthritis

Abstract

Background: rheumatoid arthritis (RA) is worldwide prevalent autoimmune disease. Associated with abnormal liver functions, and the medications used for RA are often hepatotoxic. Furthermore non treated RA patients also have liver problem. Therefore, this study aimed to investigate the association between pro-inflammatory and anti-inflammatory cytokines and liver function tests in RA patients. Materials and methods: this is a case-control hospital-based study conducted from December 2017 to August 2020 in Khartoum State in Sudan. Eighty eight Sudanese patients diagnosed with rheumatoid arthritis according to American Criteria for Rheumatology (ACR) at three different hospitals (Alamal, Military and Zain hospitals), patients with age range 28-90 years old were enrolled, 84 of them were women and 4 men. And 88 apparently health control matched (age and sex). Osteopontin (OPN), interleukin17 (IL-17) and interleukin10 (IL-10) were measured using the ELISA technique. Aspartate transaminase (AST), alanine transaminase (ALT), gammaglutamyl transferase (GGT), alkaline phosphatase (ALP), total protein and albumin were estimated using full automation Mindray analyzer. Data were analyzed by using SPSS version 14 and bioinformatics tools. Results: The frequency of RA was higher among adults aged >41 years 72 (81.8%) than young adults aged ≤41 years 16 (18.2%). RA was more common in women 84 (95.5%) than in men 4 (4.5%) – approximately 21:1-fold. Mean age was (41±11.7) years old. As well as 59 (67%) were anti-CCP positive and other 29 (33%) were negative. There were significant increases in mean level of OPN and IL-10 (38.3±29.6 ng/mL and 45.9±42.9 pg/mL) when compared to control (10.1±10.6 ng/mL and 8.48±7.36 pg/mL), with (p-value 0.000 and p-value 0.000) respectively, while IL-17 exhibited insignificant difference (6.55±1.17 pg/mL), in comparing to control (10.3±8.04 pg/mL); with (p-value 0.123). As well as mean liver enzymes activities (AST, ALT and GGT) were significantly increased in RA patients (16.6±6.98 U/L, 5.62±2.59 U/L and 27.3±23.1 U/L) than control group (7.86±7.86 U/L, 2.76±3.15 U/L and 20.9±13.4 U/L) with (p-value 0.000, p-value 0.000 and p-value 0.026) respectively. Whereas ALP showed insignificant difference (70.6±21.6 U/L) compared to control (66.8±19.6 U/L) with (p-value 0.225). Total protein and albumin were significantly decreased in RA patients (6.68±0.61 g/dL and 3.91±0.40 g/dL), than control group (7.18±0.695 g/dL and 4.22±0.460 g/dL) with (p-value 0.000 and p-value 0.000) respectively. Young adults had higher abnormal IL-10 than adult RA patients (OR = 3.72, p-value 0.044). Abnormal IL-17 (OR = 5.67, p-value 0.034) was found to be increased in young-adult RA patients. No association was observed between age and OPN, and between the duration of disease and IL-10, IL-17, and OPN. Similarly, no association was noted between the types of treatment and IL-10, IL-17, and OPN, nor between IL-10, IL-17, OPN and liver parameters (AST, ALT, ALP, ALB, TP, and GGT). Conclusion: Liver enzymes are higher in RA patients, while liver proteins are lower than control. RA patients had higher OPN and IL-10. No association are observed between Pro-inflammatory, anti-inflammatory cytokines and liver function parameters in RA patients.