Diagnostic value of serum connective tissue growth factor in rheumatoid arthritis

Serum connective tissue growth factor (CTGF) is reported to be a potential biomarker for the diagnosis of rheumatoid arthritis (RA). Our study aimed to investigate the prevalence of serum CTGF and the association with the clinical features in RA patients. Serum samples were obtained from 180 patients with RA, 168 patients with other rheumatic diseases, including 43 systemic lupus erythematosus (SLE), 34 osteoarthritis (OA), 17 primary Sjogren's syndrome (pSS), 20 ankylosing spondylitis (AS), 23 psoriatic arthritis (PsA), 6 reactive arthritis (ReA), 20 systemic sclerosis (SSc), and 5 systemic vasculitis (SV), and 64 healthy individuals. The clinical and laboratory data of patients with RA were collected. Levels of CTGF in serum were measured by enzyme linked immunosorbent assay (ELISA). Associations between CTGF and the clinical features of RA were analyzed. The positivity of serum CTGF among RA patients (33.89%) was significantly higher than those of SLE (9.3%), OA (0%), AS (0%), pSS (0%), PsA (0%), ReA (0%), SSc (5%), SV (0%), and healthy controls (4.69%) (p < 0.0001). The mean concentration of serum CTGF in RA was also significantly higher than those in other rheumatic diseases and healthy controls (p < 0.001). At the cut-off value of 263.30 pg/ml, the sensitivity, specificity, positive predictive value, and negative predictive value of serum CTGF for RA were 33.89%, 96.55%, 88.41%, and 55.45%, respectively. Anti-cyclic citrullinated peptide (anti-CCP) antibody (p < 0.001), rheumatoid factor (RF) (p < 0.001), IgG (p = 0.025), and IgM (p = 0.004) in CTGF-positive patients were higher than those in CTGF-negative patients. Besides, the positive rate of serum CTGF was significantly higher in RA patients with interstitial lung disease (ILD) (53.1%, 26/49) than RA-non-ILD patients (26.7%, 35/131, p = 0.003). Serum CTGF, as a novel biomarker, has certain diagnostic value for RA. Further studies are necessary to get more knowledge for the diagnostic performance of CTGF in RA.

Automated summary

The prevalence of serum CTGF was significantly higher in RA patients compared to other rheumatic diseases and healthy controls, indicating its potential value as a diagnostic biomarker for RA. CTGF-positive patients had higher levels of anti-CCP antibody, RF, IgG, and IgM, while the presence of ILD in RA patients was associated with a higher positivity rate of serum CTGF. Further studies are needed to fully understand the diagnostic performance of CTGF in RA.