炎性贫血可能是中国类风湿关节炎患者预测疾病活动和结构损伤的指标。

Inflammatory anemia may be an indicator for predicting disease activity and structural damage in Chinese patients with rheumatoid arthritis.

机构信息

Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, No.218, Ji-xi Road, Hefei, 230022, China.

Anhui Medical University, No.81, Mei-shan Road, Hefei, 230023, China.

出版信息

Clin Rheumatol. 2020 Jun;39(6):1737-1745. doi: 10.1007/s10067-019-04873-y. Epub 2020 Jan 9.

DOI:10.1007/s10067-019-04873-y

PMID:31916111

Abstract

OBJECTIVES

This study aimed to investigate the relationship of serum hemoglobin (HB) level with disease activity and structural damage in Chinese patients with rheumatoid arthritis (RA).

METHODS

A total of 890 RA patients and 890 normal subjects were enrolled in the case-control study. A HB threshold of< 110 g/L (women) and < 120 g/L (men) was used to determine anemia. All the patients were divided into three groups: non-anemia group (HB ≥ 120 g/L (male) or 110 g/L (female)), mild anemia group ((90 g/L < HB < lower limit of normal), and medium to severe anemia group (HB ≤ 90 g/L). Serum HB level and anemia prevalence between RA patients and normal subjects were compared. Associations of HB level with disease activity, structural damage, and function of joint in different groups were also investigated.

RESULTS

The average of HB level in RA was (109.08 ± 17.96)g/l, which was lower than that in controls (136.75 ± 14.57)g/l (P < 0.001). Anemia was observed in 47% of the RA patients, while prevalence of anemia in control group was only 4.4%. In RA group, percentages of non-anemia, mild anemia, and medium to severe anemia were 47%, 38%, and 15%. Compared with non-anemia RA patients, RA patients with anemia had higher disease activity, severer structural damage and worse function of joint (P < 0.001). With the increase of anemia, the disease activity, structural damage, and dysfunction of joints increased significantly (P < 0.05-0.001). Linear regression analysis showed that HB level was negatively correlated with disease activity parameters, degree of joint destruction, and function (P < 0.05-0.001). Logistic regression indicated that serum HB level was protective factors for disease activity and structural damage in RA (P < 0.001).

CONCLUSION

HB level was significantly related to disease activity and structural damage in RA patients.Key Points• Inflammatory anemia was popular (about a half) in patients with RA.• HB level was related to disease activity and structural damage in RA patients.

摘要

目的

本研究旨在探讨血清血红蛋白（HB）水平与中国类风湿关节炎（RA）患者疾病活动度和结构损伤的关系。

方法

采用病例对照研究，共纳入 890 例 RA 患者和 890 例正常对照者。HB＜110g/L（女性）和＜120g/L（男性）为贫血界值，将所有患者分为三组：非贫血组（HB≥120g/L（男性）或 110g/L（女性））、轻度贫血组（90g/L＜HB＜正常下限）和中重度贫血组（HB≤90g/L）。比较 RA 患者与正常对照者血清 HB 水平及贫血患病率，分析不同组 HB 水平与疾病活动度、结构损伤及关节功能的关系。

结果

RA 患者 HB 平均值为（109.08±17.96）g/L，低于对照组（136.75±14.57）g/L（P＜0.001）。RA 患者贫血患病率为 47%，对照组仅为 4.4%。RA 组中，非贫血、轻度贫血和中重度贫血的比例分别为 47%、38%和 15%。与非贫血 RA 患者相比，贫血 RA 患者疾病活动度更高，结构损伤更严重，关节功能更差（P＜0.001）。随着贫血程度的增加，疾病活动度、结构损伤和关节功能障碍均显著增加（P＜0.05-0.001）。线性回归分析显示，HB 水平与疾病活动度参数、关节破坏程度和功能呈负相关（P＜0.05-0.001）。Logistic 回归分析显示，血清 HB 水平是 RA 患者疾病活动度和结构损伤的保护因素（P＜0.001）。