Correlation of level of expression of Wnt Signaling Pathway Inhibitor Dickkopf-1 with disease activity in Elderly patients of Rheumatoid Arthritis: A cross sectional study

Objective: To correlate the level of Dickkopf-1 (DKK-1) and its role in rheumatoid arthritis (RA) patients of elderly age group. Methods:  Serum samples were collected elderly RA patients fulfilling the inclusion criteria coming to Geriatric outdoor clinic between June 2018 to September 2018. DKK-1 was detected by ELISA. Serum C-reactive protein (CRP) levels, erythrocyte sedimentation rates (ESR), rheumatoid factor (RF) titers, and anti-cyclic citrullinated peptide antibody were also measured in patients with RA. Results: Twenty one patients were enrolled in study period. The serum level of DKK-1 was significantly higher in patients with severe RA with high DAS score (p < 0.01); The serum DKK-1 level was correlated with T-score (r= -0.588; p = 0.005), Z-Score(r= -0.458, p = 0.037) and the larson score of radiologic change (r = +0.673, p = 0.001) in RA, however not correlated significantly with ESR, CRP. Conclusion: DKK-1 may serve as a biomarker of bone erosion and correlates with the disease activity in RA patients of elderly age group. Keyword: DKK 1, Rheumatoid arthritis, Geriatric, Osteoporosis.