Dickkopf 1 Protein Level as a Possible Biomarker of Functional Disability and Disease Activity in Patients with Rheumatoid Arthritis

Elgawish, Mohammad Hassan; Ebaid, Amany M.; El Gehgah, Ola Ahmed Mohamed; Ateya, Marwa Abdel Monem

doi:10.21608/zumj.2025.378395.3925

Dickkopf 1 Protein Level as a Possible Biomarker of Functional Disability and Disease Activity in Patients with Rheumatoid Arthritis

Document Type : Original Article

Authors

¹ Professor of Rheumatology and Rehabilitation, Faculty of Medicine, Zagazig University

² Assistant Professor of Rheumatology and Rehabilitation, Faculty of Medicine, Zagazig University

³ Resident Doctor at Rheumatology and Rehabilitation Department, Zagazig University Hospitals

⁴ Assistant Professor of Clinical Pathology, Faculty of Medicine, Zagazig University

10.21608/zumj.2025.378395.3925

Abstract

Background: Rheumatoid arthritis (RA) is a chronic multisystem autoimmune disease affecting synovial joints. It can lead to joint destruction, deformities reduce quality of life. Dickkopf-1 (DKK-1) is recognized as endogenous inhibitory factor in wingless-related integration site (Wnt) signaling done via its binding to (LRP5/6) co-receptor, which is essential element in bone homeostasis, various tumors and autoimmune diseases.

Objectives: The aim of current study was to assess serum DKK-1 protein level among RA patients and to study its relation with functional disability and disease activity and severity of RA.

Methods: This case control study was carried out on 120 subjects, 60 RA patients and 60 healthy control subjects. All subjects were for DKK-l protein serum level and for RA patients Disease Activity score (DAS28), Steinbrocker's grading system and Rheumatoid Arthritis Severity Scale (RASS) were estimated.

Results: Serum DKK-1 protein levels were significantly greater among RA patients (5888 ± 1868) than control subjects (1524 ± 430) with P value <0.001. Higher DKK-1 serum level was significantly correlated with increased DAS-28 scores (p < 0.001) and C reactive protein (CRP) levels (p = 0.049), erythrocyte sedimentation rate (ESR) (p < 0.001), rheumatoid factor (RF) (p = 0.043), and anti-cyclic citrullinated peptide (Anti-CCP) antibody levels (p = 0.001). DKK-1 showed a sensitivity as well as a specificity of 98.33%, 88.33% respectively, at a cut-off of 2068.65 pg/ml.

Conclusions: Serum DKK-1 level could be a valuable biomarker in RA patients. Higher DKK-1 level showed significant correlation with functional impairment, disease activity and severity of RA

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