Vol. 7, Issue 1, Part A (2025)

Background: The most prevalent chronic specific autoimmune disorders are rheumatoid arthritis (RA) and hypothyroidism. Many people experience arthralgia without synovitis during the transition to RA. Dehydroepiandrosterone sulfate (DHEAS) has anti-inflammatory and immunological properties, it is linked with pathogenesis of RA and more disease activity. This work aimed to evaluate the relationship between risk of RA and DHEAS levels in patients with primary hypothyroidism.
Methods: This cross-sectional study included 50 patients, both sexes, with controlled primary hypothyroidism (Group I) and 50 healthy individuals as a control group (Group II). European Union League Against Rheumatism (EULAR) criteria for arthralgia suspicious for progression to RA score was used to assess the risk of RA. An enzyme-linked immunosorbent test was used to detect DHEAS, which was then compared with the patients' demographic, clinical, and biochemical data.
Results: DHEAS was a good predictor for RA in all cases (area under the curve (AUC)= 0.951, P<0.001), at a cutoff value <3.765 sensitivity was 97.8%, specificity was 85.5% with accuracy 91%. In hypothyroidism group (AUC= 0.925, P<0.001) at a cutoff value <5.3449 sensitivity was 95%, specificity was 96.7% with accuracy 96% and in the control (AUC= 0.954, P<0.001) at a cut off value <5.1585 sensitivity was 96%, specificity was 88% with accuracy 92%. 
Conclusion: Serum DHEAS is a good predictor for RA for both hypothyroidism and non-thyroid group with higher accuracy in hypothyroidism patients.