The assesment of anti-CCP2 levels and collagen type 1 ?1 S/s, vitamin d receptor B/b binding site polymorphisms in rheumatoid arthritis and sjogren's syndrome

Aim: To evaluate the relationship between risk allels of osteoporosis [BsmI polimorphism of vitamin D receptor (VDR) gene, Sp1 polimorphism of the collagen I alpha 1 (COLIA1) gene], biochemical markers of bone turnover and to evaluate the feasibility of using anti-CCP2, as a possible diagnostic marker for sjogren syndrome.Methods: We enrolled 48 consecutive patients from Celal Bayar University Rheumatology out patient clinic follow-up patients consisting of 17 primary Sjogren?s syndrome (Group 1), 16 Sjogren?s syndrome with rheumatoid arthritis (Group 2) and 25 rheumatoid arthritis (Group 3) female patients. Our control group consisted of age-matched 18 healthy female volunteers. COLIA1 and VDR gene polymorphisms, Dual X-ray absorptiometry (DEXA) measurements, deoxypyridinoline (DPD), urine gamma-glutamyl transferase (GGT), urine creatinine, C-reactive protein (CRP) and anti-cyclic citrullinated protein antibodies (anti-CCP2), assesments were done from the patient and the control groups. SPSS 10.0 program was used in the statistical analysis.Results: The odds ratio for secondary osteopeni and/or osteoporosis was for having at least one `s? allel 2.63 (95% CI, 0.75?9.19, p=0.131) in rheumatologic disease patients, 0.8 (95% CI, 0.093?6.85, p=0.893) in the control group, when compared with the SS homozygotes. The odds ratio for secondary osteopeni and/or osteoporosis was for having at least one `B? allel 0.636 (95% CI, 0.166?2.45, p=0.511) in rheumatologic disease patients, 1.5 (95% CI, 0.195?11.54, p=0.697) 0.8 (95% CI, 0.093?6.85, p=0.893) in the control group, when compared with the bb homozygotes. When the relationships of COLIA1 and VDR genotypes with bone mineral density (BMD), DPD, and urine GGT/urine kreatinine levels were assessed in terms of genotypes in rheumatologic disease patients group and control group no significant relationship was found, whereas in within groups evaluations, neck BMD (p=0.033) and wards BMD (p=0.049) levels in rheumatologic patient group were statistically lower and DPD levels (p=0.002) were statistically higher relative to the control group. Anti-CCP2 positivity (>25 U/mL) in Group 1, Group 2, Group 3 was found as 11.8%, 62.5% and 28% respectively. The calculated sensitivity, specificity, pozitif predictivity, negatif predictivity for anti-CCP2 was, in the Sjogren group 11.8%, 100%, 100%, 45%, in the RA+Sjogren group 62.5%, 100%, 100%, 75% and in the RA group 28%, 100%, 100%, 50% respectively.Conclusions: BMD levels in rheumatologic patient group were statistically lower and DPD levels were statistically higher relative to the control group. The statistical insignificance in genetic assesments could be related to the limited number of patients in groups, further research is needed conducted with larger populations.Key Words: Osteoporosis, Rheumatoid arthritis, Sjogren?s syndrome, Collagen, Deoxypyridinoline, Gene polymorphism, Bone mineral density.