Introduction
Patient and methods
Study subjects
Study procedures
RA (n = 22) | At risk for RA (n = 45) | Healthy control (n = 16) |
P value | |
---|---|---|---|---|
Age (years) | 60 (46–64) | 50 (41–55) | 50 (43–59) | 0.048 |
Female (n (%)) | 15 (68) | 32 (71) | 9 (56) | 0.58 |
BMI (kg/m2) | 25.0 (21.7–27.8) | 25.8 (23.4–30.1) | 23.8 (22.5–25.7) | 0.20 |
Alcohol use (n (%)) | 11 (50) | 22 (49) | 13 (81) | 0.08 |
Current smoker (n (%)) | 4 (18) | 14 (31) | 1 (6) | 0.14 |
Cigarettes/daya
| 18 (13–25) | 10 (5–15) | 20 (20–20) | 0.12 |
Pack yearsa
| 40.5 (27.5–50.5) | 12.5 (10.0–25.0) | 34 (34.0–34.0) | 0.09 |
IgM-RF positive (n (%)) | 19 (86) | 32 (71) | 0 (0) | NA |
IgM-RF titer (kU/l)b
| 277 (144–360) | 126 (89–261) | NA | NA |
ACPA positive (n (%)) | 17 (77) | 29 (64) | 0 (0) | NA |
ACPA titer (kAU/L)b
| 379 (104–982) | 375 (109–1003) | NA | NA |
Disease duration (months) | 10 (2–85) | NA | NA | NA |
VAS GDA (mm) | 47 (27–64) | 31 (15–54) | 0 (0–0) | NA |
TJC28 (n) | 5 (4–8) | 1 (0–3) | 0 (0–0) | NA |
SJC28 (n) | 2 (2–5) | 0 (0–0) | 0 (0–0) | NA |
ESR (mm/h) | 15 (8–27) | 5 (2–9) | 2 (2–5) | NA |
CRP (mg/l) | 4.6 (2.0–10.3) | 1.4 (0.8–4.0) | 1.4 (0.6–3.5) | NA |
DAS28 | 4.32 (3.69–4.82) | NA | NA | NA |
NSAIDs (n (%)) | 10 (46) | 15 (33) | 0 (0) | NA |
Corticosteroids (n (%)) | 6 (27) | 0 (0) | 0 (0) | NA |
Methotrexate (n (%)) | 17 (77) | 0 (0) | 0 (0) | NA |
HCQ (n (%)) | 3 (14) | 0 (0) | 0 (0) | NA |
Statistical analysis
Results
RA (n = 22) | Healthy controls (n = 16) |
P valueb
| At risk for RA (n = 45) |
P valuec
| |
---|---|---|---|---|---|
Catecholamines | |||||
Epinephrine (nmol/L) | 0.17 (0.03–0.34) | 0.15 (0.06–0.18) | 0.47 | 0.17 (0.06–0.26) | 0.64 |
NE (nmol/L) | 2.45 (1.51–3.26) | 2.15 (1.49–2.71) | 0.41 | 3.02 (2.24–4.15) | 0.017 |
HPA axis response | |||||
ACTH (ng/L)a
| 19.3 (12.1–26.9) | 18.7 (13.4–23.6) | 0.97 | 19.2 (12.7–27.5) | 0.99 |
Cortisol (nmol/L)a
| 349 (246–457) | 319 (288–366) | 0.87 | 323 (222–422) | 0.96 |
IL-6 (pg/ml) | 27.7 (9.3–80.9) | 7.5 (0.9–66.7) | 0.22 | 25.1 (3.8–54.5) | 0.23 |
Cortisol/IL-6 ratioa
| 13.8 (3.0–16.9) | 16.7 (3.2–93.0) | 0.48 | 11.4 (5.3–35.1) | 0.80 |
Sex hormones | |||||
Estradiol (nmol/L) | 0.03 (0.02–0.08) | 0.05 (0.03–0.09) | 0.23 | 0.04 (0.02–0.08) | 0.52 |
FSH (IU/L) | 15.1 (7.2–49.7) | 6.4 (3.8–57.3) | 0.30 | 8.0 (3.2–71.7) | 0.60 |
LH (IU/L) | 12.4 (4.9–26.2) | 3.9 (3.0–27.7) | 0.28 | 7.1 (3.9–33.6) | 0.45 |
Prolactin (μg/L) | 9 (7–17) | 10 (7–12) | 0.73 | 9 (7–13) | 0.95 |
Other hormones | |||||
GH (mU/L) | 2.10 (1.00–2.90) | 1.35 (0.20–3.00) | 0.17 | 1.1 (0.50–3.20) | 0.22 |
TSH (mU/L) | 1.85 (1.20–2.70) | 1.90 (1.60–2.15) | 0.80 | 1.55 (1.25–2.50) | 0.51 |
Peptides | |||||
TGs (mmol/L) | 1.03 (0.75–1.29) | 0.70 (0.59–1.02) | 0.036 | 0.94 (0.72–1.15) | 0.11 |
FFAs (mmol/L) | 0.59 (0.47–0.65) | 0.40 (0.35–0.50) | 0.011 | 0.53 (0.40–0.59) | 0.024 |
Glucagon (ng/L) | 87 (75–107) | 82 (68–94) | 0.15 | 89 (74–99) | 0.34 |
Glucose (mmol/L) | 5.1 (4.8–5.4) | 5.2 (4.8–5.4) | 0.89 | 5.2 (4.8–5.4) | 0.77 |
Insulin (pmol/L) | 78 (41–94) | 54 (32–62) | 0.13 | 57 (43–100) | 0.32 |
PP (pmol/L) | 34 (23–58) | 10 (6–27) | 0.004 | 31 (21–45) | 0.003 |
Most hormone levels are comparable in at-risk individuals, patients with RA and healthy controls
FFAs are elevated in at-risk individuals and correlated with disease activity parameters
At risk for RA (n = 45) baseline |
At risk who did not developed arthritis (n = 42) baseline
|
At risk who developed arthritis (n = 3) baseline
|
P value |
At risk who developed arthritis (n = 2) arthritis visit
| |
---|---|---|---|---|---|
Catecholamines | |||||
Epinephrine (nmol/L) | 0.17 (0.06–0.26) |
0.17 (0.06–0.27) |
0.13 (0.03–0.19) |
0.42
|
0.08 (0.03–0.12) |
NE (nmol/L) | 3.02 (2.24–4.15) |
2.96 (2.42–4.20) |
3.14 (1.70–3.50) |
0.78
|
2.24 (1.85–2.62) |
HPA axis response | |||||
ACTH (ng/L)a
| 19.2 (12.7–27.5) |
19.3 (12.7–27.5) |
13.1 (9.3–36.4) |
0.65
|
23.7 (13.7–33.6) |
Cortisol (nmol/L)a
| 323 (222–422) |
341 (222–428) |
279 (135–287) |
0.12
|
304 (270–337) |
IL-6 (pg/ml) | 25.1 (3.8–54.5) |
25.5 (2.1–54.5) |
22.6 (18.1–163.3) |
0.49
|
60.8 (30.6–91.0) |
Cortisol/IL-6 ratioa
| 11.4 (5.3–35.1) |
12.1 (5.3–40.9) |
7.4 (1.7–12.7) |
0.34
|
7.0 (3.0–11.0) |
Sex hormones | |||||
Estradiol (nmol/L) | 0.04 (0.02–0.08) |
0.04 (0.02–0.08) |
0.10 (0.02–0.42) |
0.32
|
0.16 (0.08–0.24) |
FSH (IU/L) | 8.0 (3.2–71.7) |
8.1 (3.2–71.7) |
4.4 (1.6–107.9) |
0.62
|
3.4 (3.0–3.8) |
LH (IU/L) | 7.1 (3.9–33.6) |
7.8 (3.8–33.6) |
4.3 (3.9–47.6) |
0.95
|
4.6 (3.3–5.9) |
Prolactin (μg/L) | 9 (7–13) |
9 (7–14) |
8 (7–10) |
0.63
|
9 (7–11) |
Other hormones | |||||
GH (mU/L) | 1.1 (0.50–3.20) |
1.05 (0.30–3.70) |
1.30 (1.10–2.20) |
0.65
|
1.50 (1.40–1.60) |
TSH (mU/L) | 1.55 (1.25–2.50) |
1.60 (1.30–2.40) |
0.70 (0.59–2.60) |
0.23
|
1.13 (0.55–1.70) |
Peptides | |||||
TGs (mmol/L) | 0.94 (0.72–1.15) |
0.94 (0.71–1.15) |
1.01 (0.90–1.38) |
0.54
|
1.02 (0.78–1.25) |
FFAs (mmol/L) | 0.53 (0.40–0.59) |
0.53 (0.40–0.61) |
0.53 (0.37–0.55) |
0.57
|
0.45 (0.42–0.49) |
Glucagon (ng/L) | 89 (74–99) |
89 (71–99) |
89 (76–95) |
0.89
|
97 (95–99) |
Glucose (mmol/L) | 5.2 (4.8–5.4) |
5.2 (4.8–5.4) |
5.2 (5.0–5.8) |
0.51
|
5.1 (5.0–5.5) |
Insulin (pmol/L) | 57 (43–100) |
60 (43–103) |
57 (35–73) |
0.60
|
50 (26–73) |
PP (pmol/L) | 31 (21–45) |
31 (21–41) |
65 (6–112) |
0.42
|
43 (6–80) |