1053 Available online at www.medicinescience.org ORIGINAL ARTICLE Medicine Science 2020;9(4):1053-60 Clinical correlation and determination of Dkk-1 and sclerostin levels in patients with rheumatoid arthritis Zeynep Sarican Aydemir 1 , Gurkan Akgol 2 , Arif Gulkesen 2 , Arzu Kaya 2 , Dilara Kaman 3 , Hasan Ulusoy 4 1 Tarsus State Hospital, Department of Physical Medicine and Rehabilitation, Mersin, Turkey 2 Firat University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Elazig, Turkey 3 Firat University, Faculty of Medicine, Department of Medical Biochemistry and Clinical Biochemistry, Elazig, Turkey 4 Ondokuz Mayis University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation and Rheumatology, Bolu, Turkey Received 28 May 2020; Accepted 04 August 2020 Available online 25.11.2020 with doi: 10.5455/medscience.2020.06.097 Abstract The aim of this study is to compare serum Sclerostin and Dickkopf-1 (Dkk-1) levels in patients with rheumatoid artrithis (RA) and healty controls to determine their clinical signifcance in patients with RA. Sixty with RA according to American Collage of Rhematology criteria and at least one year follow up, enrolled in this study and compared thırty healty controls. To evaluate disease activity score 28 (DAS28) was calculated. Physical function capasity (disability) was asssessed with Health Assesment Quastionnarie (HAQ) and Nottingham Health Profle (NHP). Erythrocyte Sedimentation Rate, C Reactive Protein, Rheumatoid Factor and anticyclic citrullinated peptide levels were determined by routine laboratory methods. Serum sclerostin and Dkk-1 levels of the patients with RA and healty controls were measured by ELISA. Radio- graphic assesment of hands joints was evaluated according to the modifed Larsen score. Between patients with RA and healty controls, there was signifcant difference with respect to the age (respectively p=0.00) and signifcant difference with respect to gender (p=0.033). Serum sclerostin and dickkopf-1 levels were signifcantly higher (p=0.002, p=0.049) in patients with RA compared to healty controls. Serum sclerostin and dickkopf-1 levels were doesnt correlated with clinical and laboratory parameters of disease activity. There was no signifcant correlation between radiological scoring of joint damage and serum sclerostin and dickkopf-1levels (p 0.05). This study shows that Serum sclerostin and dickkopf-1 levels were increased in RA patients in comparison to control group but there was no signifcant correlation with the disease activity and joint damage. The sample of our study can be enlarged and further studies are required. Keywords: Rheumatoid artrithis, sclerostin, dickkopf-1 Introduction Rheumatoid arthritis (RA) is a progressive, chronic systemic disease and afficts several organs, however, damage to joints is the most dramatic feature. In particular, wrist and small hand joints are the most common and the frst affected areas [1]. According to the studies conducted, the prevalence of RA is between 0.3% and 1.5% [2]. The disease has a close relationship with age and gender. The female / male incidence rate is accepted as an average of 3/1. 80% of the patients are between the ages of 35 and 50 [3]. It has been suggested that many factors play a role in the etiopathogenesis of RA. Many mechanisms such as genetic factors, infectious agents and the pathogenic and immune infammatory responses triggered by them, disorders of autoimmunity against articular cartilage and synovia, and disorders in the regulation of proinfammatory cytokines have been blamed for the disease [4]. Although joints are the most affected area in rheumatoid arthritis, the disease has extra-articular involvement. In addition to systemic bone loss, local bone loss, characterized by periarticular osteopenia and focal bone erosions, is also observed in RA [5]. There are many factors that affect the pathogenesis of osteoporosis in rheumatoid arthritis. It has been shown that increase in osteoclast activity during the erosion process and inhibition of the new bone formation by WNT pathway take an important role in pathogenesis. High disease activity, drugs used in treatment such as glucocortoids, age, body mass index, gender and physical inactivity are risk factors for osteoporosis. The optimal treatment for the rudimentary disease is important to regulate the lifestyle and prevent and treat OP [6]. Recently, studies have been conducted on the increasing levels of sclerostine and dickkopf-1, two inhibitors of the WNT signaling pathway, in patients with rheumatoid arthritis and the disease is associated with damage to the joint and bone. WNT proteins are synthesized by hematopoietic cells, basal cells at the bottom of the epithelial tissue, blood vessels, adult stem cells *Coresponding Author: Gurkan Akgol, Firat University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Elazig, Turkey E-mail: drgurkanakgol@gmail.com Medicine Science International Medical Journal