Toussirot E, Nguyen N U, Dumoulin G, Aubin F, Cédoz J-P, Wendling D
Department of Rheumatology, University Hospital Jean Minjoz, Bd Fleming, 25030 Besançon cedex, France.
Rheumatology (Oxford). 2005 Jan;44(1):120-5. doi: 10.1093/rheumatology/keh421. Epub 2004 Oct 5.
Hormonal factors playing a role in bone mass and body composition have been rarely assessed in rheumatoid arthritis (RA). In this study, we aimed to evaluate the growth hormone (GH)-insulin-like growth factor-I (IGF-I)-insulin-like growth factor binding protein-3 (IGFPB-3) axis and serum leptin levels in patients with RA and to determine whether these hormonal/growth factors may influence bone mass and body composition in RA.
Serum GH, IGF-I, IGFPB-3 and leptin were evaluated in 38 corticosteroid-treated RA patients, 14 non-RA patients under corticosteroids (corticosteroid controls, CC) and 32 healthy controls (HC). Bone density was evaluated using dual X-ray absorptiometry (DEXA), and expressed as bone mineral density (BMD), and quantitative ultrasound (QUS). Body composition was assessed by DEXA.
The three groups differed regarding femoral neck, total body BMD, lean mass and QUS parameters with lower values in the RA group (all P < or = 0.05). Growth hormone was higher in RA patients (P=0.0001) while IGF-I and IGFBP-3 did not differ between the three groups. In RA patients there was a tendency to high serum leptin levels and leptin strongly correlated with fat mass (r=0.83, P<0.0001), but not with bone mass measurements or inflammatory parameters. There were no differences for lean mass, GH and leptin between CC and HC.
Our results suggest that these GH and leptin modifications could have an influence on both bone mass and body composition in RA.
在类风湿关节炎（RA）中，很少评估影响骨量和身体成分的激素因素。在本研究中，我们旨在评估RA患者的生长激素（GH）-胰岛素样生长因子-I（IGF-I）-胰岛素样生长因子结合蛋白-3（IGFPB-3）轴及血清瘦素水平，并确定这些激素/生长因子是否会影响RA患者的骨量和身体成分。
对38例接受皮质类固醇治疗的RA患者、14例接受皮质类固醇治疗的非RA患者（皮质类固醇对照，CC）和32例健康对照（HC）进行血清GH、IGF-I、IGFPB-3和瘦素评估。使用双能X线吸收法（DEXA）评估骨密度，并表示为骨矿物质密度（BMD），以及定量超声（QUS）。通过DEXA评估身体成分。
三组在股骨颈、全身BMD、瘦体重和QUS参数方面存在差异，RA组的值较低（所有P≤0.05）。RA患者的生长激素较高（P = 0.0001），而三组之间的IGF-I和IGFPB-3无差异。RA患者血清瘦素水平有升高趋势，且瘦素与脂肪量密切相关（r = 0.83，P < 0.0001），但与骨量测量值或炎症参数无关。CC组和HC组在瘦体重、GH和瘦素方面无差异。
我们的结果表明，这些GH和瘦素的改变可能会影响RA患者的骨量和身体成分。
