Background Not only joint destruction but also muscle wasting due to rheumatoid cachexia has been problem in terms of quality of life with RA. In this case control prospective study we want to show a relation between disease activity and serum creatinin kinase-a marker, which reflects muscle mass-levels in active RA patients.
Methods Age matched 71 female RA patients as study group and 34 female osteoarthritis patients as control group were included in to the study. Patient's data including acute phase reactants (erythrocyte sedimentation rate-ESR and C-reactive protein-CRP), rheumatoid factor (RF) and anti-CCP positivity and disease activity scores (DAS28-RA) were collected. Serum creatinin kinase (CK) levels were measured.
Results RA patients group: DAS28: 5.79±1.29; ESR: 69±31 mm/h; CRP 32.5±40 IU/L; RF: 183±23.1 IU/mL; CCP: 91.5IU/mL. 18 patients were obese (BMI>30) and remaining patients' BMI<30. 56 patients were using steroids and mean steroid dose was 5.13±2.8 mg/daily. All patients were in at least one disease-modifying antirheumatic drugs (DMARDs) therapy alone or in combination. Mean CK level was 38±25 mg/dL.
OA control group: ESR 23±16 mm/h, CRP: 7.3±4.4 IU/L; RF: 18.3±34.8 IU/mL, CCP: 24.0±15.6 IU/L. 16 of controls were obese (BMI>30), the remaining controls were in normal ranges (BMI<30). None of the controls were using steroids. Mean CK level was 73±34mg/dL.
“Pearson's Correlation Analysis” was performed. P<0.05 was accepted as significant. There was a significant difference between the study and control groups about the CK levels (p<0.004). Inverse correlation between DAS 28 and serum CK levels were significant (p<0.001).
Conclusions Increased activity was accompanied by a decrease in serum creatinin kinase. From 1978 we know that in active RA, urinary creatinin excretion was invariably increased according to the disease activity. Therefore, inflammation could be characterized as double-edge sword, requiring a balance between health as maintained by regular exercise and activities that would exacerbate inflammatory response. In RA patient population exercise is necessary to prevent muscle contractions and mobility. Type of exercise should be well decided and balanced in RA patients.
Helliwell PS, Jackson S. Ann Rheum Dis 1994; 53:726-28.
Kramer HR, Fontaine KR, Bathon JM. Arthritis Rheum 2012 Aug; 64(8): 2438-50.
Disclosure of Interest None declared