Laboratory of Nursing Theory and Fundamentals, Institute of Nursing and Midwifey, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Department of Medical Physiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland.
Rheumatol Int. 2023 May;43(5):859-866. doi: 10.1007/s00296-023-05296-4. Epub 2023 Mar 13.
Rheumatoid arthritis (RA) is a chronic systemic connective tissue disease of autoimmune basis. It is characterized by inflammation of joints and systemic complications. The etiopathogenesis is still unknown. Predisposing factors for the disease include genetic, immunological and environmental. Chronic disease and the stress experienced by patients disrupt the body's homeostatic state and weaken the human immune system. Reduced immunity and endocrine disruption may influence the development of autoimmune diseases and exacerbate their course. The aim of the study was to investigate whether there is a relationship between the blood levels of hormones such as cortisol, serotonin, melatonin and the clinical status of RA patients as determined by the DAS28 index and CRP protein. A total of 165 people participated in the study of these 84 subjects had RA and the rest were the control group. All participants completed a questionnaire and had their blood drawn to determine hormones. Patients with RA had higher plasma cortisol (324.6 ng/ml vs. 292.9 ng/ml) and serotonin concentrations (67.9 ng/ml vs. 22.1 ng/ml) and lower plasma melatonin (116.8 pg/ml vs. 330.2 pg/ml) compared to controls. Patients whose CRP concentration were above normal also had elevated plasma cortisol concentration. No significant association was observed in RA patients between plasma melatonin, serotonin and DAS28 values. However, it can be concluded that those with high disease activity had lower melatonin levels as compared to patients with low and moderate DAS28 values. Significant differences were found between RA patients not using steroids and plasma cortisol (p = 0.035). In RA patients, it was observed that as plasma cortisol concentration increased, the chance of having an elevated DAS28 score, indicating high disease activity, increased.
类风湿关节炎（RA）是一种慢性全身性自身免疫性结缔组织疾病。其特征为关节炎症和全身并发症。其病因仍然未知。疾病的诱发因素包括遗传、免疫和环境因素。慢性疾病和患者经历的压力破坏了身体的平衡状态并削弱了人类的免疫系统。免疫力下降和内分泌失调可能会影响自身免疫性疾病的发展并使病程恶化。本研究旨在探讨血液中皮质醇、血清素、褪黑素等激素水平与 DAS28 指数和 CRP 蛋白确定的 RA 患者临床状况之间是否存在关系。共有 165 人参与了这些研究，其中 84 人患有 RA，其余为对照组。所有参与者都完成了一份问卷并抽取了血液以确定激素水平。与对照组相比，RA 患者的血浆皮质醇（324.6ng/ml 比 292.9ng/ml）和血清素浓度（67.9ng/ml 比 22.1ng/ml）更高，而血浆褪黑素（116.8pg/ml 比 330.2pg/ml）更低。CRP 浓度高于正常值的患者也有较高的血浆皮质醇浓度。RA 患者的血浆褪黑素、血清素与 DAS28 值之间未观察到显著相关性。但是，可以得出结论，与 DAS28 值低和中度的患者相比，疾病活动度高的患者褪黑素水平较低。未使用类固醇的 RA 患者与血浆皮质醇之间存在显著差异（p=0.035）。在 RA 患者中，观察到随着血浆皮质醇浓度的增加，DAS28 评分升高（表示疾病活动度高）的可能性增加。
