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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #153436
Title: CACHEXIA IN RHEUMATIOID ARTHRITIS IS NOT EXPLAINED BY DECREASED GROWTH HORMONE SECRETION

Author
item RALL, LAURA - UNIVERSITY OF WISCONSIN
item WALSMITH, JOSEPH - TUFTS UNIVERSITY
item SNYDMAN, LAURA - TUFTS UNIVERSITY
item REICHLIN, SEYMOUR - UNIVERSITY OF ARIZONA
item VELDHUIS, JOHANNES - UNIVERSITY OF VIRGINIA
item KEHAYIAS, JOSEPH - TUFTS UNIVERSITY
item ABAD, LESLIE - SCHERING PLOUGH
item LUNDGREN, NANCY - DECEASED
item ROUBENOFF, RONENN - TUFTS-HNRCA

Submitted to: Arthritis and Rheumatism
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/27/2002
Publication Date: 10/1/2002
Citation: RALL, L.C., WALSMITH, J.M., SNYDMAN, L., REICHLIN, S., VELDHUIS, J.D., KEHAYIAS, J.J., ABAD, L.W., LUNDGREN, N.T., ROUBENOFF, R. CACHEXIA IN RHEUMATIOID ARTHRITIS IS NOT EXPLAINED BY DECREASED GROWTH HORMONE SECRETION. ARTHRITIS AND RHEUMATISM. 2002;46:2574-77.

Interpretive Summary: Patients with rheumatoid arthritis (RA) experience a loss of body cell (primarily muscle) mass, leading to a condition termed 'rheumatoid cachexia'. Consequences include physical inactivity, loss of strength, and decreased ability to perform usual activities of daily living. Many factors contribute to this loss of body cell mass, including diet, medications, physical inactivity itself, and disease-related changes in hormones and other mediators of the immune system (cytokines). One hormone that may play a role in the loss of body cell mass in RA is growth hormone (GH). This study was undertaken to elucidate the possible role of altered GH in loss of body cell mass in RA. Body cell mass was found to be reduced in patients with RA compared with healthy control subjects. There was no difference in body fat mass between the two groups of subjects. Growth hormone measurements in patients with RA did not differ from those in healthy controls. These findings suggest that GH levels are unchanged in patients with RA compared with healthy subjects. Growth hormone deficiency does not appear to account for rheumatoid cachexia. This study is important in that it contributes to an understanding of the role that various factors have in the etiology of RA.

Technical Abstract: Patients with rheumatoid arthritis (RA) lose body cell mass (BCM) by unknown mechanisms. Since the loss of BCM in normal aging individuals parallels the characteristic age-related decline in growth hormone (GH) secretion, this study was carried out to determine whether further decreased GH secretion plays a role in the pathogenesis of this loss of BCM in RA patients, termed "rheumatoid cachexia". GH secretory kinetics were determined by deconvolution analysis in 16 patients with RA and 17 healthy controls matched for age (mean +/- SD 45.4 +/- 13.2 years and 47.1 +/- 14.6 years, respectively), sex, race, and body mass index. Blood samples were obtained every 20 minutes for 24 hours. Body composition was ascertained using total-body potassium (TBK) as a measure of BCM and dual x-ray absorptiometry to determine fat mass. BCM was reduced in patients with RA compared with healthy controls (mean +/- SD gm TBK 79.5 +/- 9.5 versus 94.9 +/- 11.9; P < 0.0005), but there was no difference in fat mass. GH kinetic parameters in patients with RA did not differ from those in controls. These findings suggest that GH kinetics are unaltered in RA patients compared with healthy subjects; thus, GH deficiency does not account for rheumatoid cachexia.