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Investigation of Periodontitis, Halitosis, Xerostomia, and Serological Characteristics of Patients with Osteoarthritis and Rheumatoid Arthritis and Identification of New Biomarkers

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Journal Sci Rep
Specialty Science
Date 2024 Feb 21
PMID 38383594
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Abstract

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.

References
1.
Elsayed Ramadan D, Hariyani N, Indrawati R, Ridwan R, Diyatri I . Cytokines and Chemokines in Periodontitis. Eur J Dent. 2020; 14(3):483-495. PMC: 7440949. DOI: 10.1055/s-0040-1712718. View

2.
Metz C . Basic principles of ROC analysis. Semin Nucl Med. 1978; 8(4):283-98. DOI: 10.1016/s0001-2998(78)80014-2. View

3.
Nagler R, Salameh F, Reznick A, Livshits V, Nahir A . Salivary gland involvement in rheumatoid arthritis and its relationship to induced oxidative stress. Rheumatology (Oxford). 2003; 42(10):1234-41. DOI: 10.1093/rheumatology/keg362. View

4.
Serdaroglu M, Cakirbay H, Deger O, Cengiz S, Kul S . The association of anti-CCP antibodies with disease activity in rheumatoid arthritis. Rheumatol Int. 2008; 28(10):965-70. PMC: 2493537. DOI: 10.1007/s00296-008-0570-3. View

5.
Pearle A, Scanzello C, George S, Mandl L, DiCarlo E, Peterson M . Elevated high-sensitivity C-reactive protein levels are associated with local inflammatory findings in patients with osteoarthritis. Osteoarthritis Cartilage. 2006; 15(5):516-23. DOI: 10.1016/j.joca.2006.10.010. View