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AIM: The soluble scavenger receptor differentiation antigen 163 (sCD163), a monocyte/macrophage activation marker, is related to cardiovascular mortality in the general population. This study aimed to evaluate their relationship between serum levels of sCD163 with cardiovascular risk indicators in rheumatoid arthritis (RA). METHODS: A cross-sectional study was performed on 80 women diagnosed with RA. The cardiovascular risks were determined using the lipid profile, metabolic syndrome, and QRISK3 calculator. For the assessment of RA activity, we evaluated the DAS28 with erythrocyte sedimentation rate (DAS28-ESR). The serum levels of sCD163 were determined by the ELISA method. Logistic regression models and receiver operating characteristics (ROC) curve were used to assess the association and predictive value of sCD163 with cardiovascular risk in RA patients. RESULTS: Levels of sCD163 were significantly higher in RA patients with high sensitivity protein C-reactive to HDL-c ratio (CHR)≥0.121 (p=0.003), total cholesterol/HDL-c ratio>7% (p=0.004), LDL-c/HDL-c ratio>3% (p=0.035), atherogenic index of plasma>0.21 (p=0.004), cardiometabolic index (CMI)≥1.70 (p=0.005), and high DAS28-ESR (p=0.004). In multivariate analysis, levels of sCD163≥1107.3ng/mL were associated with CHR≥0.121 (OR=3.43, p=0.020), CMI≥1.70 (OR=4.25, p=0.005), total cholesterol/HDL-c ratio>7% (OR=6.63, p=0.044), as well as with DAS28-ESR>3.2 (OR=8.10, p=0.008). Moreover, levels of sCD163 predicted CHR≥0.121 (AUC=0.701), cholesterol total/HDL ratio>7% (AUC=0.764), and DAS28-ESR>3.2 (AUC=0.720). CONCLUSION: Serum levels of sCD163 could be considered a surrogate of cardiovascular risk and clinical activity in RA.

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Background and objective The aim of this research was to investigate the relationship between disease activity and health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) considering the increased interest in the management of this disease. Materials and methods HRQoL was measured at clinic visits during a 12-month follow-up period using questionnaires on fatigue (FACIT-FATIGUE); quality of life, EuroQol 5-dimension (EQ-5D-5L) health questionnaire with 5 levels; disability, Health Assessment Questionnaire (HAQ), and a Global Health Status (GHS) scale. Disease activity, organ damage and other clinical factors that could affect HRQoL were recorded. The association between disease activity and HRQoL was assessed using Bayesian linear regression models with monotonic effects. Results Data from 70 patients at the baseline visit and 42 patients with 1 year of follow-up were analyzed. At baseline, 28.57% of patients presented Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)>6. In the 70 baseline patients, disease activity was associated with HRQoL in all four parameters. In the 42 patients with 12 months of follow-up, the positive association of disease activity with GHS, FACIT-FATIGUE and EQ-5D-5L and the negative association with HAQ was maintained.Patients who are smokers and those receiving immunosuppressant therapy presented low GHS and FACIT-FATIGUE scores. Moreover, older age at inclusion was significantly associated to low GHS, while low leucocyte and 25-OH-vitamin D levels were associated to fatigue perception in SLE patients. Conclusion Our results showed a statistically significant association between disease activity and HRQoL parameters. (AU)

Objetivo El objetivo del estudio fue analizar la relación entre la actividad clínica y la calidad de vida relacionada con la salud (CVRS) en pacientes con lupus eritematoso sistémico (LES).Material y métodos La CVRS se evaluó en la visita basal y durante 12 meses de seguimiento mediante un cuestionario de fatiga (FACIT-FATIGUE), calidad de vida (EQ-5D-5L), discapacidad (HAQ) y una escala analógica visual de estado general de salud (EVA). La actividad clínica, el daño acumulado y otros factores clínicos que pudieran afectar a la CVRS se analizaron mediante un modelo de regresión lineal bayesiano con efectos monotónicos. Resultados Se analizaron los datos de 70 pacientes incluidos en la visita basal y los 42 con 12 meses de seguimiento seleccionados aleatoriamente. En la visita basal el 28,57% de los pacientes presentaban un índice SLEDAI>6. La actividad clínica medida mediante el índice SLEDAI se asociaba de forma estadísticamente significativa a los 4 parámetros de CVRS. En los 42 pacientes con un año de seguimiento la relación directa entre la actividad clínica y el FACIT-FATIGUE, EVA y EQ-5D-5L, así como la relación indirecta con el HAQ, se mantuvieron. Los pacientes fumadores y aquellos bajo tratamiento inmunosupresor presentaban valores disminuidos de EVA y FACIT-FATIGUE. Además, los pacientes con edades más avanzadas presentaban valores disminuidos de EVA, y aquellos con niveles bajos de vitamina D o leucopenia presentaban mayor percepción de fatiga. Conclusión La actividad clínica se asocia a diferentes dominios de la CVRS, apoyando la evaluación de la CVRS como complemento en el manejo del LES. (AU)

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Introducción: El lupus eritematoso sistémico (LES) es una enfermedad autoinmune con severidad variable, frecuente en individuos hispanos y afroamericanos. Objetivo: Conocer la actividad clínica y el daño acumulado, así como la prevalencia e incidencia, en una cohorte dinámica de pacientes con LES de la península de Yucatán (1995 a 2016). Pacientes y métodos: Se analizaron 200 pacientes con LES, beneficiarios del servicio médico del Hospital Regional ISSSTE de Mérida, Yucatán, durante 22 años. Se evaluó la actividad de la enfermedad y el daño acumulado mediante la escala MEX-SLEDAI y SLICC-ACR-DI, respectivamente, y su correlación con variables clínicas y demográficas. Resultados: Se analizaron 185 pacientes mujeres y 15 hombres. Los índices promedio de actividad y daño acumulado durante el seguimiento fueron de 4,63 y 1,10, respectivamente. El índice de actividad se observó significativamente menor en las mujeres respecto de los hombres (4,36 vs. 7,43), y el daño acumulado no presentó diferencia por sexo. Las manifestaciones asociadas con mayor actividad fueron las mucocutáneas y articulares, y los órganos con mayor daño acumulado el musculoesquelético, el neurológico y el gonadal. Se encontró relación de los índices con el tiempo de evolución, las remisiones/reactivaciones y la actividad persistente. La mortalidad se relacionó con actividad persistente por complicaciones vasculares sistémicas e insuficiencia renal y hepática. La incidencia y prevalencia anual del LES calculada fue de 2,86% y 48,43% en la península de Yucatán. Conclusiones: Los pacientes presentaron actividad persistente, con reactivaciones leves a moderadas y daño acumulado más agresivo en hombres. La actividad clínica disminuye e incrementa el daño acumulado a mayor tiempo de evolución, con menor afección renal y mayor sobrevida, lo que sugiere un curso más benigno en la población de la península de Yucatán.(AU)

IntroductionSystemic lupus erythematosus (SLE) is an autoimmune with variable severity, common in Hispanic and African-American individuals.Objective: To know the clinical activity and the accumulated damage, as well as the prevalence and incidence, in a dynamic cohort of patients with SLE from the Yucatan Peninsula (1995-2016). Patients and methods: A cohort of 200 patients with SLE, medical service beneficiaries of the ISSSTE Regional Hospital of Mérida, Yucatán, was analyzed for 22 years. Disease activity and accumulated damage were evaluated using the MEX-SLEDAI scale and the SLICC-ACR-DI, respectively, and its correlation with clinical and demographic variables. Results: 185 female and 15 male patients were analyzed. Average accumulated damage and activity indices during follow-up were 4.63 and 1.10, respectively. The activity index was significantly lower in females compared to males (4.36 vs 7.43), and the accumulated damage did not present a difference by sex. The manifestations associated with greater activity were the mucocutaneous and articular ones, and the organs with the greatest accumulated damage were the musculoskeletal, neurological and gonadal. A relationship between the indices was found with the evolution time, remissions / reactivations, and persistent activity. Mortality was related to persistent activity due to systemic vascular complications and kidney and liver failure. The annual incidence and prevalence of SLE calculated was 2.86% and 48.43% in Yucatán Peninsula. Conclusions: The patients presented persistent activity, with mild to moderate reactivations, and accumulated damage more aggressive in men. The clinical activity decreases and increases the accumulated damage at a longer evolution time, with less kidney disease and greater survival, which suggests a more benign course in the population of the Yucatan Peninsula.(AU)

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BACKGROUND AND OBJECTIVE: The aim of this research was to investigate the relationship between disease activity and health-related quality of life (HRQoL) in patients with systemic lupus erythematosus (SLE) considering the increased interest in the management of this disease. MATERIALS AND METHODS: HRQoL was measured at clinic visits during a 12-month follow-up period using questionnaires on fatigue (FACIT-FATIGUE); quality of life, EuroQol 5-dimension (EQ-5D-5L) health questionnaire with 5 levels; disability, Health Assessment Questionnaire (HAQ), and a Global Health Status (GHS) scale. Disease activity, organ damage and other clinical factors that could affect HRQoL were recorded. The association between disease activity and HRQoL was assessed using Bayesian linear regression models with monotonic effects. RESULTS: Data from 70 patients at the baseline visit and 42 patients with 1 year of follow-up were analyzed. At baseline, 28.57% of patients presented Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)>6. In the 70 baseline patients, disease activity was associated with HRQoL in all four parameters. In the 42 patients with 12 months of follow-up, the positive association of disease activity with GHS, FACIT-FATIGUE and EQ-5D-5L and the negative association with HAQ was maintained. Patients who are smokers and those receiving immunosuppressant therapy presented low GHS and FACIT-FATIGUE scores. Moreover, older age at inclusion was significantly associated to low GHS, while low leucocyte and 25-OH-vitamin D levels were associated to fatigue perception in SLE patients. CONCLUSION: Our results showed a statistically significant association between disease activity and HRQoL parameters.

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INTRODUCTION: Systemic lupus erythematosus (SLE) is an autoimmune with variable severity, common in Hispanic and African-American individuals. OBJECTIVE: To know the clinical activity and the accumulated damage, as well as the prevalence and incidence, in a dynamic cohort of patients with SLE from the Yucatan Peninsula (1995-2016). PATIENTS AND METHODS: A cohort of 200 patients with SLE, medical service beneficiaries of the ISSSTE Regional Hospital of Mérida, Yucatán, was analysed for 22 years. Disease activity and accumulated damage were evaluated using the MEX-SLEDAI scale and the SLICC-ACR-DI, respectively, and its correlation with clinical and demographic variables. RESULTS: 185 female and 15 male patients were analysed. Average accumulated damage and activity indices during follow-up were 4.63 and 1.10, respectively. The activity index was significantly lower in females compared to males (4.36 vs 7.43), and the accumulated damage did not present a difference by sex. The manifestations associated with greater activity were the mucocutaneous and articular ones, and the organs with the greatest accumulated damage were the musculoskeletal, neurological and gonadal. A relationship between the indices was found with the evolution time, remissions/reactivations, and persistent activity. Mortality was related to persistent activity due to systemic vascular complications and kidney and liver failure. The annual incidence and prevalence of SLE calculated was 2.86% and 48.43% in Yucatán Peninsula. CONCLUSIONS: The patients presented persistent activity, with mild to moderate reactivations, and accumulated damage more aggressive in men. The clinical activity decreases and increases the accumulated damage at a longer evolution time, with less kidney disease and greater survival, which suggests a more benign course in the population of the Yucatan Peninsula.

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Introducción: La artritis reumatoide tiene un importante impacto sobre la función física y la productividad laboral. Objetivo: Determinar la productividad laboral de los pacientes con artritis reumatoide temprana identificando su relación con variables sociodemográficas y clínicas. Método: Se realizó un estudio observacional descriptivo de corte transversal en 53 pacientes atendidos en el Centro de Referencia de Enfermedades Reumáticas entre enero a diciembre de 2019. Para evaluar la productividad laboral se utilizó el cuestionario WPAI-AR. Resultados: Predominaron los pacientes entre los 35-55 años de edad (60,4 por ciento), el sexo femenino (60,4 por ciento). La productividad laboral medida a través de WPAI-AR reportó durante los últimos 7 días una media de 4,64 horas laborales perdidas, secundaria a la artritis reumatoide, con un porciento de pérdida por ausentismo del 16,5 por ciento y presentismo del 59,6 por ciento. Conclusiones: El mayor porciento de afectación de la productividad laboral le correspondió al presentismo. Se encontró asociación entre la pérdida de productividad laboral y la actividad clínica, la discapacidad funcional y la calidad de vida relacionada con la salud(AU)

Introduction: rheumatoid arthritis has been reported to have a significant impact on physical function and work productivity. Objectives: To determine the labor productivity of patient's diagnosis with early rheumatoid arthritis and to identify its possible relationship with sociodemographic and clinical variables. Methods: A cross-sectional descriptive observational study was carried out in 53 patients treated at the Reference Center for Rheumatic Diseases between January to December 2019. To evaluate labor productivity, the WPAIR AR questionnaire was used. Results: patients between 35-55 years of age predominated 60.4 percent, the female sex 60.4 percent. Labor productivity measured by WPAI AR reported during the last 7 days an average of 4.64 working hours lost, secondary to early rheumatoid arthritis, with a percentage of loss due to absenteeism of 16.5 percent and presenteeism of 59.6 percent. Conclusion: Conclusion: the highest percentage of affectation of labor productivity corresponded to labor presenteeism. Loss of work productivity was significantly associated with clinical activity, functional capacity, and health-related quality of lifepor ciento(AU)

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Introducción: Los anticuerpos contra el citoplasma del neutrófilo se detectan normalmente en pacientes con vasculitis. Aunque estos anticuerpos pueden estar presentes en un amplio número de enfermedades asociadas a estados inflamatorios y autoinmunes, como la artritis reumatoide, no se ha demostrado su significado clínico. Objetivo: evaluar la utilidad de diferentes especificidades antigénicas de los anticuerpos contra el citoplasma del neutrófilo para medir la actividad clínica en pacientes cubanos con artritis reumatoide. Material y Métodos: Se realizó un estudio transversal con 77 pacientes cubanos con artritis reumatoide. Se determinaron la velocidad de sedimentación globular, la proteína C reactiva, el indicador clínico de actividad de la enfermedad, los anticuerpos anti-proteínas citrulinadas, el factor reumatoide y los anticuerpos contra el citoplasma del neutrófilo frente a diferentes especificidades antigénicas. Resultados: La mayor cantidad de pacientes con actividad clínica elevada (> 5,1) pertenecieron al grupo de pacientes positivos de anticuerpos contra el citoplasma del neutrófilo (p=0,0364). Los pacientes con anticuerpos anti-lactoferrina tuvieron mayores valores de actividad clínica (p=0,0304). Mediante análisis multivariado se demostró la influencia de la positividad de anticuerpos anti-lisozima (p=0,0391), de la positividad doble de los anticuerpos anti-proteínas citrulinadas y anti-lactoferrina (p=0,0282), así como de la doble positividad de los anticuerpos anti-proteínas citrulinadas y anti-elastina (p=0,0182) en la actividad clínica. Conclusión: La presencia de anticuerpos contra el citoplasma del neutrófilo que reconocen las especificidades antigénicas lisozima, lactoferrina y elastina se relacionan con mayor actividad clínica en pacientes con artritis reumatoide(AU)

Introduction: Antibodies against neutrophil cytoplasm are normally detected in patients with vasculitis. Although these antibodies can be present in a wide number of diseases associated with inflammatory and autoimmune conditions such as rheumatoid arthritis, their clinical significance has not been demonstrated. Objective: To evaluate the usefulness of different antigenic specificities of antibodies against neutrophil cytoplasm to measure the clinical activity in Cuban patients with rheumatoid arthritis. Material and Methods: A cross-sectional study was conducted on 77 Cuban patients with rheumatoid arthritis. Erythrocyte sedimentation rate, C-reactive protein, the clinical indicator of disease activity, anti-citrullinated protein antibodies, rheumatoid factor, and antibodies against neutrophil cytoplasm against different specificities were determined. Results: The largest number of patients with elevated disease activity (> 5.1) belonged to the group of antibodies against neutrophil cytoplasm positive patients (p=0.0364). Patients with anti-lactoferrin antibodies had higher disease activity values ​​(p=0.0304). Through multivariate analysis, the influence of positive anti-lysozyme antibodies (p=0.0391), of double positivity of anti-citrullinated protein and anti-lactoferrin antibodies (p=0.0282), as well as that of double positivity of anti-citrullinated protein and anti-elastin antibodies (p=0.0182) on disease activity were demonstrated. Conclusion: The antibodies against neutrophil cytoplasm that recognize the antigenic specificities of lysozyme, lactoferrin and elastin are related to higher clinical activity in patients with rheumatoid arthritis(AU)

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Introducción: La artritis reumatoide es una enfermedad autoinmune, inflamatoria, sistémica y crónica que se caracteriza por la afectación de pequeñas articulaciones y causa distintos grados de discapacidad funcional y disminución de la percepción de la calidad de vida relacionada con la salud. Objetivo: Determinar la relación existente entre el estado nutricional y la actividad clínica en pacientes con diagnóstico de artritis reumatoide. Métodos: Estudio descriptivo y correlacional de 96 pacientes con diagnóstico de artritis reumatoide, según los criterios del American College of Rheumatology, quienes fueron atendidos en el Hospital Andino de Chimborazo. Se determinó el estado nutricional mediante el índice de masa corporal y la actividad clínica mediante el sistema Disease Activity Score-28 (DAS 28). Se utilizó la prueba de correlación de Pearson para hallar la relación existente entre el estado nutricional y la actividad clínica. Resultados: El promedio de edad fue de 64,23 años; predominaron los pacientes de 60 años o más (51,04 por ciento) y del sexo femenino (78,12 por ciento). El 67,71 por ciento de los casos presentaban comorbilidades asociadas, específicamente hipertensión arterial (43,07 por ciento), hipotiroidismo (35,38 por ciento) y fibromialgia (32,31 por ciento). El 37,50 por ciento tenía sobrepeso y el 16,67 por ciento, obesidad; el 46,88 por ciento de los pacientes presentó actividad clínica ligera y el 29,17 por ciento moderada. El 14,58 por ciento se encontraba en remisión. Conclusiones: Existe una relación positiva considerable entre el estado nutricional y la actividad clínica de la artritis reumatoide en la población estudiada, conclusión que se basa en el resultado del coeficiente de correlación de Pearson(AU)

Introduction: rheumatoid arthritis is an autoimmune, inflammatory, systemic and chronic disease that is characterized by the involvement of small joints of the hands and feet generating different degrees of functional disability and decreased perception of health-related quality of life. Objective: to determine the relationship between nutritional status and clinical activity in patients diagnosed with rheumatoid arthritis. Methods: descriptive and correlational study in 96 patients diagnosed with rheumatoid arthritis according to the criteria of the American College of Rheumatology who were treated at the Andean Hospital of Chimborazo. Nutritional status was determined by body mass index and clinical activity by DAS 28. Pearson's correlation test was used to determine the relationship between nutritional status and clinical activity. Results: average age of 64.23 years, patients between 60 years or older (51.04 percent) and female (78.12 percent) predominated. 67.71 percent of the cases presented comorbidities associated with a predominance of arterial hypertension (43.07 percent), hypothyroidism (35.38 percent) and fibromyalgia (32.31 percent). Overweight was present in 37.50 percent and obesity in 16.67 percent of cases; 46.88 percent of the patients presented mild clinical activity and 29.17 percent moderate, 14.58 percent were in remission. Conclusions: the presence of nutritional alterations due to excess (overweight and obesity) positively influence the clinical activity of patients with rheumatoid arthritis, finding a significant positive correlation between them(AU)

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Introducción: la normativa actual de docencia clínica regula el desarrollo de actividades curriculares disminuyendo el tiempo de con-tacto estudiante-paciente, requiriendo entre otras destrezas del estudiante la lectura eficiente de información clínica. La simulación permite desarrollar competencias clínicas en los estudiantes de ciencias de la salud. El objetivo de este estudio es describir la experiencia de talleres de fichas clínicas simuladas (FCS) en estudiantes curriculares y reportar indicadores de logro de objetivos de aprendizaje relacionados al reconocimiento de las partes de la ficha clínica e identificación y extracción de información relevante. Metodología: en una asignatura de carácter mínimo previo al encuentro de estudiantes con pacientes reales, se desarrollaron cuatro talleres de FCS en grupo pequeño. Un académico guió la actividad consistente en responder cuestionarios de ubicación de información presente en las FCS. Al finalizar la asignatura, se evaluó la percepción de la didáctica educativa y logro de objetivos de aprendizaje en tutores clínicos y estudiantes mediante encuesta. Resultados: los estudiantes reportaron alta satisfacción con la metodología, facilidad para extraer información relevante y mayor tiempo de contacto clínico con pacientes reales. Los tutores clínicos informaron que los estudiantes logran reconocer las partes de la ficha clínica. Ambos consideran que el tiempo ideal para lectura de ficha clínica es de 10 a 20 minutos.Conclusión: la incorporación de talleres de fichas clínicas simuladas desarrolló habilidades clínicas de reconocimiento de las partes que componen la ficha clínica, optimizando el tiempo necesario para identificar y extraer información relevante a diferentes escenarios clínicos.

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BACKGROUND AND OBJECTIVE: to analyse the association between interferon-1α (INF1α), interleukin-10 (IL-10) and BLyS concentrations and clinical activity in systemic lupus erythematosus (SLE). PATIENTS AND METHODS: A cross-sectional, observational study of 142 SLE patients and 34 healthy controls was performed, through a complete blood and urine test and review of their medical history. Serum concentration of INF1α, IL-10 and BLyS was determined by colorimetric methods. A biostatistical analysis was performed with R (3.3.2.). RESULTS: 69% of our SLE patients showed at least one cytokine increased. INF1α, IL-10 and BLyS are higher in SLE patients than in healthy controls (P<.001, P=.005 and P=.043, respectively), being INF1α the most frequent. Patients were categorised according to low or high concentrations of the three cytokines. We found a significant association between increased IL-10/INF1α concentrations and a higher clinical activity measured by SELENA-SLEDAI (P<.0001) and, to a lesser extent, an association with increased INF1α/IL-10/BLyS concentrations. Elevated levels of IL-10/INF1α and INF1α/IL-10/BLyS related to increased C3-C4 consumption (P<.001 and P=.001 respectively) and anti-dsDNA titres (P=.001 and P=.002 respectively). Elevated INF1α/BLyS related to higher anti-dsDNA titres (P=.004) and ENA positivity (P<.001). Increased levels of INF1α/IL-10/BLyS related to positivity of ANAs (P<.001) and APL (P=.004). CONCLUSIONS: INF1α, IL-10 and BLyS are higher in SLE patients than in healthy controls. Increased IL-10 levels, regardless of whether or not there were also increased levels of BLyS and/or INF1α, was the cytokine that best fit with clinical activity in SLE measured with classic methods.

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OBJECTIVES: Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting diarthrodial joints, in which patients tend to perform less physical activity (PA) than recommended. This review focuses on the existing evidence about the relationship of PA and RA, specifically how the former influences joint inflammation, disability, quality of life and pain in RA patients, and also how disease activity potentially impacts PA in these patients. METHODS: A literature search of EMBASE and MEDLINE databases from January 2000 to January 2015. RESULTS: The evidence indicating that PA in RA patients is safe and the benefits from regularly performing, both aerobic and resistance exercises, in these patients include improvement in: quality of life, functionality, pain and number of swollen joints. Interestingly, recent studies suggest that changes in disease activity in RA patients inversely correlate with variations in PA, as assessed by accelerometry. CONCLUSIONS: The regular monitoring of PA in RA patients might facilitate a more objective evaluation of variations in disease activity, helping physicians to make general and therapeutic recommendations that will improve both the health status and the joint functionality of these patients.

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OBJECTIVE: To evaluate the association between the clinical activity of RA patients and serum adipocytokines (Leptin, Adiponectin and Resistin) and inflammatory cytokines. METHODS: All RA patients fulfilled ACR 1987 criteria and were treated with DMARDs. Adipocytokine and inflammatory cytokine levels were evaluated using ELISA. RESULTS: 121 patients were included in the study. Stratifying according to DAS28 (low, moderate and high activity), there were significant differences for Leptin, Resistin, IL-6 and IL-17, however, no differences were seen for Adiponectin, TNFα or IL-1ß. Clinical activity positively correlated with Leptin, Resistin, IL-17 and IL-6 levels, but not with Adiponectin, TNFα or IL-1ß. Adiponectin levels negatively correlated with TNFα and positively correlated with IL-1ß. IL-1ß positively correlated with IL-6 and negatively correlated with TNFα and IL-17. CONCLUSION: Circulating Leptin, Resistin, IL-6 and IL-17 levels positively correlate with RA clinical activity in a manner independent of the subject's BMI. Complex relationships between inflammatory cytokines were observed in RA patients suggesting that other metabolic or inflammatory factors could be involved.

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BACKGROUND AND OBJECTIVES: Endoscopy is the gold standard to assess disease severity in inflammatory bowel disease, although it is an invasive procedure. Clinical activity and biological markers have been routinely used to determine disease activity in a non-invasive manner. The aim of this study was to determine concordance between common biological markers (C reactive protein, orosomucoid, erythrocyte sedimentation rate, fibrinogen, platelets, leukocytes, neutrophils and haemoglobin) and clinical activity in inflammatory bowel disease. PATIENTS AND METHOD: Consecutive patients with inflammatory bowel disease were included. Clinical activity was evaluated according to the Harvey-Bradshaw index in Crohn's disease and to the partial Mayo score in ulcerative colitis. Serum concentrations of the different biomarkers were analysed. Concordance between clinical activity and elevation of the serological biomarkers was determined using the kappa statistic. RESULTS: In total, 350 patients were included (median age 46 years, Crohn's disease 59%). Eleven percent of patients had clinical activity. Crohn's disease patients had mild clinical activity in 44% of cases, moderate disease in 44% and only 12% of patients had severe clinical activity. In ulcerative colitis, patients had mild, moderate and severe clinical activity in 50, 42 and 8% of cases, respectively. None of the biomarkers included had an acceptable concordance with clinical activity (kappa statistic ≤ 0.30). CONCLUSIONS: Concordance between serological biomarkers and clinical activity in inflammatory bowel disease is remarkably low.

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