<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medecol</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина и экология</journal-title><trans-title-group xml:lang="en"><trans-title>Medicine and ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2305-6045</issn><issn pub-type="epub">2305-6053</issn><publisher><publisher-name>Карагандинский медицинский университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.59598/ME-2305-6053-2026-120-3-89-99</article-id><article-id custom-type="elpub" pub-id-type="custom">medecol-1379</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКАЯ МЕДИЦИНА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL MEDICINE</subject></subj-group></article-categories><title-group><article-title>Ассоциация между активностью заболевания и АЦЦП-статусом при раннем ревматоидном артрите: поперечное исследование</article-title><trans-title-group xml:lang="en"><trans-title>Association between disease activity and anti-CCP status in early rheumatoid arthritis: a cross-sectional study</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Vasilchenko@qmu.kz</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Pokrashenko</surname><given-names>O. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ольга Александровна Покрашенко </p><p>100008, г. Караганда, ул. Гоголя, 40</p></bio><bio xml:lang="en"><p>Olga Alexandrovna Pokrashenko</p><p>100008, Karaganda c., Gogolya str., 40</p></bio><email xlink:type="simple">Vasilchenko@qmu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тайжанова</surname><given-names>Д. Ж.</given-names></name><name name-style="western" xml:lang="en"><surname>Taizhanova</surname><given-names>D. Zh.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100008, г. Караганда, ул. Гоголя, 40</p></bio><bio xml:lang="en"><p>100008, Karaganda c., Gogolya str., 40</p></bio><email xlink:type="simple">info@qmu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дробченко</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Drobchenko</surname><given-names>Y. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100008, г. Караганда, ул. Гоголя 40</p></bio><bio xml:lang="en"><p>100008, Karaganda c., Gogolya str., 40</p></bio><email xlink:type="simple">info@qmu.kz</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шалыгина</surname><given-names>А.</given-names></name><name name-style="western" xml:lang="en"><surname>Shalygina</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>100008, г. Караганда, ул. Гоголя, 40</p></bio><bio xml:lang="en"><p>100008, Karaganda c., Gogolya str., 40</p></bio><email xlink:type="simple">info@qmu.kz</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Кафедра внутренних болезней, НАО «Карагандинский медицинский университет»</institution><country>Казахстан</country></aff><aff xml:lang="en"><institution>Department of Internal Diseases, NC JSC «Karaganda medical university»</institution><country>Kazakhstan</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Кафедра информатики и биостатистики, НАО «Карагандинский медицинский университет»</institution><country>Казахстан</country></aff><aff xml:lang="en"><institution>Department of Informatics and Biostatistics, NC JSC «Karaganda medical university»</institution><country>Kazakhstan</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2026</year></pub-date><pub-date pub-type="epub"><day>12</day><month>10</month><year>2026</year></pub-date><volume>0</volume><issue>3</issue><fpage>89</fpage><lpage>99</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Vasilchenko@qmu.kz О.А., Тайжанова Д.Ж., Дробченко Е.А., Шалыгина А.A., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Vasilchenko@qmu.kz О.А., Тайжанова Д.Ж., Дробченко Е.А., Шалыгина А.</copyright-holder><copyright-holder xml:lang="en">Pokrashenko O.A., Taizhanova D.Z., Drobchenko Y.A., Shalygina A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://medecol.qmu.kz/jour/article/view/1379">https://medecol.qmu.kz/jour/article/view/1379</self-uri><abstract><sec><title>Введение</title><p>Введение. Ревматоидный артрит является широко распространенным заболеванием, приводящим к инвалидности, при котором решающее значение имеет ранняя диагностика. Возникновение заболевания, как правило, связано с множеством факторов риска; однако его этиология до сих пор не до конца изучена. В настоящее время повышение осведомленности пациентов и широкий доступ к лабораторной диагностике этого заболевания позволяют своевременно выявлять его и назначать соответствующее лечение в соответствии с клиническими рекомендациями.</p></sec><sec><title>Цель</title><p>Цель. Оценить особенности проявления ревматоидного артрита на основе клинической картины у пациентов на ранней стадии заболевания, а также определить взаимосвязь между факторами риска, уровнем антител к циклическому цитруллинированному пептиду и активностью заболевания DAS-28 (индекс активности заболевания 28).</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. В 2025 – 2026 гг. было проведено поперечное исследование с участием 48 пациентов с ревматоидным артритом на ранней стадии с целью выявления закономерностей проявления заболевания. Был проведен опрос пациентов, включая определение пораженных групп суставов и сопутствующих факторов риска. Активность заболевания оценивали с помощью шкалы DAS28, и пациенты были разделены на группы с низкой, умеренной и высокой активностью. Для определения взаимосвязи между анти-CCP статусом и показателями DAS28 использовали коэффициент корреляции Спирмена.</p></sec><sec><title>Результаты и обсуждение</title><p>Результаты и обсуждение. Активность заболевания была низкой в 10,42% случаев, умеренной – в 68,75 %, высокой – в 20,83%. У пациентов с положительным результатом теста на антитела к цитруллинированным пептидам (анти-CCP) показатели DAS28 были ниже, чем у пациентов с отрицательным результатом теста на анти-CCP. Корреляционный анализ по Спирмену продемонстрировал статистически значимую слабую отрицательную корреляцию между уровнями анти-CCP и показателями DAS28 (rs = –0,28; p=0,048).</p></sec><sec><title>Заключение</title><p>Заключение. Таким образом, в исследовании с участием 48 пациентов у большинства лиц с ревматоидным артритом на ранней стадии наблюдалась умеренная активность заболевания, что было связано с высокой распространенностью положительных результатов на антитела к циклическим цитруллинированным пептидам (анти-CCP). Лабораторное исследование на наличие антител к циклическим цитруллинированным пептидам у пациентов с проявлениями суставного синдрома может иметь потенциальную клиническую ценность на доклинической стадии ревматоидного артрита.</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Rheumatoid arthritis is a prevalent, disabling disease in which early diagnosis is crucial. The onset of the disease is generally associated with multiple risk factors; however, its etiology remains not fully understood. Currently, increased patient awareness and broad access to laboratory diagnostics for this condition enable timely detection and subsequent administration of appropriate treatment in accordance with clinical guidelines.</p></sec><sec><title>Aim</title><p>Aim. To evaluate patterns of rheumatoid arthritis manifestation based on clinical presentation in patients at an early stage of the disease, and to determine the  association between risk factors, the status of antibodies to cyclic citrullinated peptide, disease activity (Disease Activity Score 28).</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A cross-sectional study was conducted on 48 patients with early-stage rheumatoid arthritis between 2025 and 2026 to identify patterns in the manifestation of the disease.  Patients were surveyed, including identification of affected joint groups and associated risk factors. Disease activity was assessed using the DAS28, and patients were divided into groups with low, moderate, and high. Spearman’s correlation was used to determine the relationship between anti-CCP status and DAS28 scores.</p></sec><sec><title>Results and discussion</title><p>Results and discussion. Disease activity was low in 10.42% of cases, moderate in 68.75%, and high in 20.83%. Patients with a positive anti-citrullinated peptide (anti-CCP) antibody test had lower DAS28 scores compared to those with a negative anti-CCP antibody test. Spearman’s correlation analysis demonstrated a statistically significant weak negative correlation between anti-CCP status and DAS28 scores (rs = –0.28; p = 0.048).</p></sec><sec><title>Conclusion</title><p>Conclusion. Thus, in this study of 48 patients, most individuals with early-stage rheumatoid arthritis exhibited moderate disease activity, which was associated with a high prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibody positivity. Laboratory testing for the presence of antibodies to cyclic citrullinated peptides in patients with manifestation of articular syndrome may have potential clinical value in the  preclinical stages of rheumatoid arthritis.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>ревматоидный артрит</kwd><kwd>факторы риска</kwd><kwd>антитела к цитруллинированным белкам</kwd><kwd>DAS-28</kwd><kwd>ранний ревматоидный артрит</kwd></kwd-group><kwd-group xml:lang="en"><kwd>arthritis</kwd><kwd>rheumatoid</kwd><kwd>risk factors</kwd><kwd>anti-citrullinated protein antibodies</kwd><kwd>DAS-28</kwd><kwd>early rheu-   matoid arthritis</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Di Matteo A., Emery P. Rheumatoid arthritis: a review of the key clinical features and ongoing challenges of the disease. Panminerva Med. 2024; 66: 427-442. https://doi.org/10.23736/S0031-0808.24.05272-8</mixed-citation><mixed-citation xml:lang="en">Di Matteo A., Emery P. Rheumatoid arthritis: a review of the key clinical features and ongoing challenges of the disease. Panminerva Med. 2024; 66: 427-442. https://doi.org/10.23736/S00310808.24.05272-8</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Далибаева Г.К., Габдулина Г.Х., Калмаханов С.Б. Потенциальные факторы риска и причины развития ревматоидного артрита. Фармация Казахстана. 2024; 3 (254): 59-68. https://doi.org/10.53511/pharmkaz.2024.65.23.007</mixed-citation><mixed-citation xml:lang="en">Dalibaeva G.K., Gabdulina G.H., Kalmahanov S.B. Potencial’nye faktory riska i prichiny razvitija revmatoidnogo artrita. Farmacija Kazahstana. 2024; 3 (254): 59-68. https://doi.org/10.53511/pharmkaz.2024.65.23.007</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Venetsanopoulou A.I., Alamanos Y., Voulgari P.V., Drosos A.A. Epidemiology and Risk Factors for Rheumatoid Arthritis Development. Mediterr. J. Rheumatol. 2023; 34 (4): 404-413. https://doi.org/10.31138/mjr.301223.eaf</mixed-citation><mixed-citation xml:lang="en">Venetsanopoulou A.I., Alamanos Y., Voulgari P.V., Drosos A.A. Epidemiology and Risk Factors for Rheumatoid Arthritis Development. Mediterr. J. Rheumatol. 2023; 34 (4): 404-413. https://doi.org/10.31138/mjr.301223.eaf</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Гульнева М.Ю., Носков С.М., Носкова Т.С., Малафеева Э.В. Качество жизни и микробиоценоз кишечника больных ревматоидным артритом. Архивъ внутренней медицины. 2014; (4): 17-20. https://doi.org/10.20514/2226-6704-2014-0-4-17-20</mixed-citation><mixed-citation xml:lang="en">Gul’neva M.Ju., Noskov S.M., Noskova T.S., Malafeeva Je.V. Kachestvo zhizni i mikrobiocenoz kishechnika bol’nyh revmatoidnym artritom. Arhiv vnutrennej mediciny. 2014; (4): 17-20. https://doi.org/10.20514/2226-6704-2014-0-4-17-20</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Василевский И.В. Связь дисбактериоза кишечника с ревматоидным артритом. Дни ревматологии в Санкт-Петербурге – 2021. СПб; 2021: 39-41.</mixed-citation><mixed-citation xml:lang="en">Vasilevskij I.V. Svjaz’ disbakterioza kishechnika s revmatoidnym artritom. Dni revmatologii v Sankt-Peterburge – 2021. SPb; 2021: 39-41.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Farquharson D., Butcher J.P., Culshaw S. Periodontitis, porphyromonas, and the pathogenesis of rheumatoid arthritis. Mucosal. Immunol. 2012; 5 (2): 112-120. https://doi.org/10.1038/mi.2011.6623</mixed-citation><mixed-citation xml:lang="en">Farquharson D., Butcher J.P., Culshaw S. Periodontitis, porphyromonas, and the pathogenesis of rheumatoid arthritis. Mucosal. Immunol. 2012; 5 (2): 112-120. https://doi.org/10.1038/mi.2011.66 23</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Mikuls T.R., Payne J.B., Yu F., Thiele G.M., Reynolds R.J., Cannon G.W., Markt J., McGowan D., Kerr G.S., Redman R.S., Reimold A., Griffiths G., Beatty M., Gonzalez S.M., Bergman D.A., Hamilton B.C., Erickson A.R., Sokolove, J., Robinson W.H., Walker C., Chandad F., O’Dell J.R. Periodontitis and Porphyromonas gingivalis in Patients With Rheumatoid Arthritis. Arthritis&amp;Rheumatology. 2014; 66 (5): 1090-1100. https://doi.org/10.1002/art.38348</mixed-citation><mixed-citation xml:lang="en">Mikuls T.R., Payne J.B., Yu F., Thiele G.M., Reynolds R.J., Cannon G.W., Markt J., McGowan D., Kerr G.S., Redman R.S., Reimold A., Griffiths G., Beatty M., Gonzalez S.M., Bergman D.A., Hamilton B.C., Erickson A.R., Sokolove, J., Robinson W.H., Walker C., Chandad F., O’Dell J.R. Periodontitis and Porphyromonas gingivalis in Patients With Rheumatoid Arthritis. Arthritis&amp;Rheumatology. 2014; 66 (5): 1090-1100. https://doi.org/10.1002/art.38348</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Quirke A.M., Lugli E.B., Wegner N., Hamilton B.C., Charles P., Chowdhury M., Ytterberg A.J., Zubarev R.A., Potempa J., Culshaw S., Guo Y., Fisher B.A., Thiele G., Mikuls T.R., Venables P.J. Heightened immune response to autocitrullinated Porphyromonas gingivalis peptidylarginine deiminase: a potential mechanism for breaching immunologic tolerance in rheumatoid arthritis. Ann. Rheum. Dis. 2014; 73: 263-269. https://doi.org/10.1136/annrheumdis-2012-202726</mixed-citation><mixed-citation xml:lang="en">Quirke A.M., Lugli E.B., Wegner N., Hamilton B.C., Charles P., Chowdhury M., Ytterberg A.J., Zubarev R.A., Potempa J., Culshaw S., Guo Y., Fisher B.A., Thiele G., Mikuls T.R., Venables P.J. Heightened immune response to autocitrullinated Porphyromonas gingivalis peptidylarginine deiminase: a potential mechanism for breaching immunologic tolerance in rheumatoid arthritis. Ann. Rheum. Dis. 2014; 73: 263-269. https://doi.org/10.1136/annrheumdis-2012-202726</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Pradeepkiran J.A. Insights of rheumatoid arthritis risk factors and associations. J. Transl. Autoimmun. 2019; 2: 100012. https://doi.org/10.1016/j.jtauto.2019.100012</mixed-citation><mixed-citation xml:lang="en">Pradeepkiran J.A. Insights of rheumatoid arthritis risk factors and associations. J. Transl. Autoimmun. 2019; 2: 100012. https://doi.org/10.1016/j.jtauto.2019.100012</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Dai X., Li P., Pan D. Research trends in estrogen and rheumatoid arthritis: a systematic bibliometric approach. Biol. Sex Differ. 2025; 17 (1): 18. https://doi.org/10.1186/s13293-025-00806-4</mixed-citation><mixed-citation xml:lang="en">Dai X., Li P., Pan D. Research trends in estrogen and rheumatoid arthritis: a systematic bibliometric approach. Biol. Sex Differ. 2025; 17 (1): 18. https://doi.org/10.1186/s13293-025-00806-4</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Meyer P.W., Anderson R., Ker J.A., Ally M.T. Rheumatoid arthritis and risk of cardiovascular disease. Cardiovasc. J. Afr. 2018; 29 (5): 317-321. https://doi.org/10.5830/CVJA-2018-018</mixed-citation><mixed-citation xml:lang="en">Meyer P.W., Anderson R., Ker J.A., Ally M.T. Rheumatoid arthritis and risk of cardiovascular disease. Cardiovasc. J. Afr. 2018; 29 (5): 317-321. https://doi.org/10.5830/CVJA-2018-018</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Дибров Д.А., Авдеева А.С., Рыбакова В.В., Демидова Н.В., Насонов Е.Л. Клинические особенности АЦЦП-негативного и АЦЦПпозитивного вариантов ревматоидного артрита. Научно-практическая ревматология. 2023; 61 (2): 207-213. https://doi.org/10.47360/1995-4484-2023-207-213</mixed-citation><mixed-citation xml:lang="en">Dibrov D.A., Avdeeva A.S., Rybakova V.V., Demidova N.V., Nasonov E.L. Klinicheskie osobennosti ACCP-negativnogo i ACCP-pozitivnogo variantov revmatoidnogo artrita. Nauchno-prakticheskaja revmatologija. 2023; 61 (2): 207-213. https://doi.org/10.47360/1995-4484-2023-207-213</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Arnett F.C., Edworthy S.M., Bloch D.A., Mcshane D.J., Fries J.F., Cooper N.S., Healey L.A., Kaplan S.R., Liang M.H., Luthra H.S., Medsger T.A., Mitchell D.M., Neustadt D.H., Pinals R.S., Schaller J.G., Sharp J.T., Wilder R.L., Hunder G.G. The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis &amp; Rheumatism. 1988; 31: 315-324. https://doi.org/10.1002/art.1780310302</mixed-citation><mixed-citation xml:lang="en">Arnett F.C., Edworthy S.M., Bloch D.A., Mcshane D.J., Fries J.F., Cooper N.S., Healey L.A., Kaplan S.R., Liang M.H., Luthra H.S., Medsger T.A., Mitchell D.M., Neustadt D.H., Pinals R.S., Schaller J.G., Sharp J.T., Wilder R.L., Hunder G.G. The american rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis &amp; Rheumatism. 1988; 31: 315-324. https://doi.org/10.1002/art.1780310302</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Aletaha D., Neogi T., Silman A.J. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis. 2010; 69 (9): 1580-1588. https://doi.org/10.1136/ard.2010.138461</mixed-citation><mixed-citation xml:lang="en">Aletaha D., Neogi T., Silman A.J. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann. Rheum. Dis. 2010; 69 (9): 1580-1588. https://doi.org/10.1136/ard.2010.138461</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Kwiatkowska B., Kłak A., Maślińska M., Mańczak M., Raciborski F. Factors of depression among patients with rheumatoid arthritis. Reumatologia. 2018; 56 (4): 219-227. https://doi.org/10.5114/reum.2018.77973</mixed-citation><mixed-citation xml:lang="en">Kwiatkowska B., Kłak A., Maślińska M., Mańczak M., Raciborski F. Factors of depression among patients with rheumatoid arthritis. Reumatologia. 2018; 56 (4): 219-227. https://doi.org/10.5114/reum.2018.77973</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Хохлова Ю.В., Инамова О.В., Шиманьски Д.А., Лесняк О.М. Влияние отказа от табакокурения на активность ревматоидного артрита, интенсивность боли и качество жизни пациентов. Научно-практическая ревматология. 2025; 63 (5): 502-509. https://doi.org/10.47360/1995-4484-2025-502-509</mixed-citation><mixed-citation xml:lang="en">Hohlova Ju.V., Inamova O.V., Shiman’ski D.A., Lesnjak O.M. Vlijanie otkaza ot tabakokurenija na aktivnost’ revmatoidnogo artrita, intensivnost’ boli i kachestvo zhizni pacientov. Nauchno-prakticheskaja revmatologija. 2025; 63 (5): 502-509. https://doi.org/10.47360/1995-4484-2025-502-509</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Papandreou P., Gioxari A., Daskalou E., Grammatikopoulou M.G., Skouroliakou M., Bogdanos D.P. Mediterranean Diet and Physical Activity Nudges versus Usual Care in Women with Rheumatoid Arthritis: Results from the MADEIRA Randomized Controlled Trial. Nutrients. 2023; 15 (3): 676. https://doi.org/10.3390/nu15030676</mixed-citation><mixed-citation xml:lang="en">Papandreou P., Gioxari A., Daskalou E., Grammatikopoulou M.G., Skouroliakou M., Bogdanos D.P. Mediterranean Diet and Physical Activity Nudges versus Usual Care in Women with Rheumatoid Arthritis: Results from the MADEIRA Randomized Controlled Trial. Nutrients. 2023; 15 (3): 676. https://doi.org/10.3390/nu15030676</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Fernández-Ávila D.G., David-Pardo D.G., Bermúdez M. Inicio de artritis reumatoide posterior a infección por SARS-CoV-2. Rev. Colomb. Reumatol. 2022; 29: 80-83. https://doi.org/10.1016/j.rcreu.2021.10.007</mixed-citation><mixed-citation xml:lang="en">Fernández-Ávila 	D.G., 	David-Pardo D.G., Bermúdez M. Inicio de artritis reumatoide posterior a infección por SARS-CoV-2. Rev. Colomb. Reumatol. 2022; 29: 80-83. https://doi.org/10.1016/j.rcreu.2021.10.007</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Slouma M., Mhemli T., Abbes M., Triki W., Dhahri R., Metoui L., Gharsallah I., Louzir B. Rheumatoid arthritis occurring after coronavirus disease 2019 (COVID-19) infection: Case based review. Egypt Rheumatol. 2022; 44 (3): 275-278. https://doi.org/10.1016/j.ejr.2022.03.001</mixed-citation><mixed-citation xml:lang="en">Slouma M., Mhemli T., Abbes M., Triki W., Dhahri R., Metoui L., Gharsallah I., Louzir B. Rheumatoid arthritis occurring after coronavirus disease 2019 (COVID-19) infection: Case based review. Egypt Rheumatol. 2022; 44 (3): 275-278. https://doi.org/10.1016/j.ejr.2022.03.001</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Baimukhamedov C., Barskova T., Matucci-Cerinic M. Arthritis after SARS-CoV-2 infection. Lancet Rheumatol. 2021; 3 (5): 324-325. https://doi.org/10.1016/S2665-9913(21)00067-9</mixed-citation><mixed-citation xml:lang="en">Baimukhamedov 	C., 	Barskova 	T., Matucci-Cerinic M. Arthritis after SARS-CoV-2 infection. Lancet Rheumatol. 2021; 3 (5): 324-325. https:// doi.org/10.1016/S2665-9913(21)00067-9</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Jahid M., Khan K.U., Rehan-Ul-Haq, Ahmed R.S. Overview of Rheumatoid Arthritis and Scientific Understanding of the Disease. MediterrJ. 2023; 34 (3): 284-291. https://doi.org/10.31138/mjr.20230801.oo</mixed-citation><mixed-citation xml:lang="en">Jahid M., Khan K.U., Rehan-Ul-Haq, Ahmed R.S. Overview of Rheumatoid Arthritis and Scientific Understanding of the Disease. MediterrJ. 2023; 34 (3): 284-291. https://doi.org/10.31138/mjr.20230801.oo</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Kronzer V.L., Davis J.M. Etiologies of Rheumatoid Arthritis: Update on Mucosal, Genetic, and Cellular Pathogenesis. Curr. Rheumatol. Rep. 2021; 23 (4): 21. https://doi.org/10.1007/s11926-02100993-0</mixed-citation><mixed-citation xml:lang="en">Kronzer V.L., Davis J.M. Etiologies of Rheumatoid Arthritis: Update on Mucosal, Genetic, and Cellular Pathogenesis. Curr. Rheumatol. Rep. 2021; 23 (4): 21. https://doi.org/10.1007/s11926-02100993-0</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Weman L., Salo H., Kuusalo L., Huhtakangas J., Kärki J., Vähäsalo P., Backström M., Sokka-Isler T. Initial presentation of early rheumatoid arthritis. PloS One. 2023; 18 (7): e0287707. https://doi.org/10.1371/journal.pone.0287707</mixed-citation><mixed-citation xml:lang="en">Weman L., Salo H., Kuusalo L., Huhtakangas J., Kärki J., Vähäsalo P., Backström M., Sokka-Isler T. Initial presentation of early rheumatoid arthritis. PloS One. 2023; 18 (7): e0287707. https://doi.org/10.1371/journal.pone.0287707</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Cîrciumaru A., Kisten Y., Hansson M., Mathsson-Alm L., Joshua V., Wähämaa H., Loberg Haarhaus M., Lindqvist J., Padyukov L., Catrina S.B., Fei G., Vivar N., Rezaei H., Af Klint E., Antovic A., Réthi B., Catrina A.I., Hensvold A. Identification of early risk factors for anti-citrullinated-protein-antibody positive rheumatoid arthritis-a prospective cohort study. Rheumatology (Oxford). 2024; 63 (11): 31643171. https://doi.org/10.1093/rheumatology/keae146</mixed-citation><mixed-citation xml:lang="en">Cîrciumaru A., Kisten Y., Hansson M., Mathsson-Alm L., Joshua V., Wähämaa H., Loberg Haarhaus M., Lindqvist J., Padyukov L., Catrina S.B., Fei G., Vivar N., Rezaei H., Af Klint E., Antovic A., Réthi B., Catrina A.I., Hensvold A. Identification of early risk factors for anti-citrullinated-protein-antibody positive rheumatoid arthritis-a prospective cohort study. Rheumatology (Oxford). 2024; 63 (11): 31643171. https://doi.org/10.1093/rheumatology/keae146</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Ilar A., Alfredsson L., Wiebert P., Klareskog L., Bengtsson C. Occupation and Risk of Developing Rheumatoid Arthritis: Results From a Population-Based Case-Control Study. Arthritis Care Res. 2018; 70 (4): 499-509. https://doi.org/10.1002/acr.23321</mixed-citation><mixed-citation xml:lang="en">Ilar A., Alfredsson L., Wiebert P., Klareskog L., Bengtsson C. Occupation and Risk of Developing Rheumatoid Arthritis: Results From a Population-Based Case-Control Study. Arthritis Care Res. 2018; 70 (4): 499-509. https://doi.org/10.1002/acr.23321</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Zaniewicz-Kaniewska K., Sudoł-Szopińska I. Usefulness of sonography in the diagnosis of rheumatoid hand. J. Ultrason. 2013; 13 (54): 329-336. https://doi.org/10.15557/JoU.2013.0033</mixed-citation><mixed-citation xml:lang="en">Zaniewicz-Kaniewska K., Sudoł-Szopińska I. Usefulness of sonography in the diagnosis of rheumatoid hand. J. Ultrason. 2013; 13 (54): 329-336. https://doi.org/10.15557/JoU.2013.0033</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Zeng P., Klareskog L., Alfredsson L. Physical workload is associated with increased risk of rheumatoid arthritis: results from a Swedish population-based case-control study. RMD Open. 2017; 3: e000324. https://doi.org/10.1136/rmdopen-2016-000324</mixed-citation><mixed-citation xml:lang="en">Zeng P., Klareskog L., Alfredsson L. Physical workload is associated with increased risk of rheumatoid arthritis: results from a Swedish population-based case-control study. RMD Open. 2017; 3: e000324. https://doi.org/10.1136/rmdopen-2016-000324</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">van Dijk B.T., Boeren A.M.P., Khidir S.J.H., den Hollander N.K., van der Helm-van Mil A.H.M. Work-related physical strain and development of joint inflammation in the trajectory of emerging inflammatory and rheumatoid arthritis: a prospective cohort study. RMD Open. 2024; 10 (2): e003895. https://doi.org/10.1136/rmdopen-2023-003895</mixed-citation><mixed-citation xml:lang="en">van Dijk B.T., Boeren A.M.P., Khidir S.J.H., den Hollander N.K., van der Helm-van Mil A.H.M. Work-related physical strain and development of joint inflammation in the trajectory of emerging inflammatory and rheumatoid arthritis: a prospective cohort study. RMD Open. 2024; 10 (2): e003895. https://doi.org/10.1136/rmdopen-2023-003895</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Buckner J., Nicassio P., Holers V.M., Deane K.D., Norris J.M. Perceived Stress and Inflammatory Arthritis: A Prospective Investigation in the Studies of the Etiologies of Rheumatoid Arthritis Cohort. Arthritis Care Res (Hoboken). 2020; 72 (12):1766-1771. https://doi.org/10.1002/acr.24085</mixed-citation><mixed-citation xml:lang="en">Buckner J., Nicassio P., Holers V.M., Deane K.D., Norris J.M. Perceived Stress and Inflammatory Arthritis: A Prospective Investigation in the Studies of the Etiologies of Rheumatoid Arthritis Cohort. Arthritis Care Res (Hoboken). 2020; 72 (12):1766-1771. https://doi.org/10.1002/acr.24085</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Nordberg L.B., Lillegraven S., Lie E., Aga A.B., Olsen I.C., Hammer H.B., Uhlig T., Jonsson M.K., van der Heijde D., Kvien T.K., Haavardsholm E.A., the ARCTIC working group. Patients with seronegative RA have more inflammatory activity compared with patients with seropositive RA in an inception cohort of DMARD-naïve patients classified according to the 2010 ACR/EULAR criteria. Ann. Rheum. Dis. 2017; 76 (2): 341-345. https://doi.org/10.1136/annrheumdis-2015-208873</mixed-citation><mixed-citation xml:lang="en">Nordberg L.B., Lillegraven S., Lie E., Aga A.B., Olsen I.C., Hammer H.B., Uhlig T., Jonsson M.K., van der Heijde D., Kvien T.K., Haavardsholm E.A., the ARCTIC working group. Patients with seronegative RA have more inflammatory activity compared with patients with seropositive RA in an inception cohort of DMARD-naïve patients classified according to the 2010 ACR/EULAR criteria. Ann. Rheum. Dis. 2017; 76 (2): 341-345. https://doi.org/10.1136/annrheumdis-2015-208873</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
