Abstract
SummaryBackgroundChronic inflammation of rheumatoid arthritis (RA) is associated with disturbances in muscle and bone metabolism.AimThe purpose of this study was to investigate whether endocrine regulators of myogenesis and bone metabolism in patients with rheumatoid arthritis (RA) in remission differed from unaffected healthy controls. An additional point was whether these were associated with patients’ health-related functioning or particular bodily functions of the International Classification of Functioning, Disability and Health (ICF).MethodsBone turnover and the markers for muscle, i.e. myostatin (MSTN), follistatin (FSTN), growth differentiation factor (GDF-15) and for bone, i.e. sclerostin (SOST), dickkopf 1 (Dkk1), periostin (PSTN) metabolism were determined in 24 female RA patients and matched healthy controls. The chair rising test (CRT), timed up and go test (TUG), 6 min walking test, maximum hand grip and back extensor strength tests were used to assess patients’ health-related functions. Additionally, bone mineral density of the lumbar spine and the hip region was measured.ResultsFor the bone turnover markers no differences were observed between patients and controls. In contrast, the markers MSTN and Dkk1 were significantly lower and FSTN and PSTN significantly higher in patients than controls. Patients performed worse in the CRT and TUG. Some correlations reflected associations between these endocrine factors and physical function.ConclusionAnti-inflammatory therapy may be responsible for the positive effect on endocrine factors influencing myogenesis. Elevation of PSTN probably reflects the increased risk of fragility fractures in RA patients.
Highlights
Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disease primarily affecting the joints, is often accompanied by rheumatoid cachexia [1]
Anti-inflammatory therapy may be responsible for the positive effect on endocrine factors influencing myogenesis
In experimental as well as human studies it has been shown that the endocrine factors myostatin (MSTN; [2]) and its counterpart follistatin (FSTN; [3]) influence skeletal muscle growth in a negative [4, 5] and a positive way [6], respectively
Summary
Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disease primarily affecting the joints, is often accompanied by rheumatoid cachexia [1]. Pain, restricted joint mobility, impaired muscle strength and decreased aerobic fitness limit patients’ physical functioning and reduce the quality of life. Biochemical parameters, performance-based tests and self-reported questionnaires may enable early detection of such limitations enabling the early initiation of countermeasures. In RA periarticular bone loss, bone erosion and systemic osteoporosis leading to an increased risk of fractures are often observed. In experimental as well as human studies it has been shown that the endocrine factors myostatin (MSTN; [2]) and its counterpart follistatin (FSTN; [3]) influence skeletal muscle growth in a negative [4, 5] and a positive way [6], respectively.
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