The Role of Serum MCP-1 in the Diagnosis and Assessment of Rheumatoid Arthritis

Background: RA is a chronic autoimmune disease characterized by synovial inflammation and joint destruction. Monocyte chemoattractant protein-1 (MCP-1) plays a key role in recruiting immune cells, contributing to both physiological immune responses and pathological conditions such as RA.  The aim of this study is to evaluate the diagnostic and prognostic role of serum MCP-1 levels in patients with rheumatoid arthritis, particularly in relation to comorbid conditions such as diabetes mellitus. Methods: A case-control study was conducted in Kerbala province between November 2024 and March 2025. It included 90 participants, comprising 20 rheumatoid arthritis (RA) patients with diabetes mellitus, 25 RA patients without diabetes, and 45 apparently healthy individuals as controls. Body mass index (BMI) was calculated, and family medical history was recorded. Laboratory measurements included serum levels of MCP-1 using Enzyme-Linked Immunosorbent Assay (ELISA), rheumatoid factor (RF), anti-cyclic citrullinated peptide (ACCP), and erythrocyte sedimentation rate (ESR). Results: ACCP and RF levels were significantly elevated in RA patients, especially those with diabetes, compared to both non-diabetic RA patients and healthy controls. Obesity was also more prevalent among diabetic RA patients. ROC curve analysis showed excellent diagnostic performance of MCP-1 in distinguishing RA patients from controls, with high sensitivity and specificity. Conclusions: The findings indicate that MCP-1, ACCP, and RF were valuable biomarkers for RA diagnosis and disease assessment, particularly in patients with metabolic comorbidities such as diabetes and obesity.