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探讨队列研究中早期类风湿关节炎患者血清催乳素与血清葡萄糖水平及临床指标的相关性。

Exploring the association of serum prolactin with serum glucose levels and clinical findings in a cohort of patients with early rheumatoid arthritis.

机构信息

University Hospital of Brasilia, Brasilia, Brazil.

Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil.

出版信息

Adv Rheumatol. 2024 Aug 7;64(1):56. doi: 10.1186/s42358-024-00394-8.

Abstract

BACKGROUND

In the context of rheumatoid arthritis and its systemic inflammatory implications, there is an increasing interest in investigating the role of prolactin in the clinical and metabolic aspects of the disease. This study aimed to explore the potential links between serum prolactin levels, serum glucose levels, and the clinical manifestations of arthritis.

METHODS

This exploratory, cross-sectional, observational study focused on women diagnosed with rheumatoid arthritis. The research involved assessing prolactin and blood glucose concentrations, alongside specific clinical traits such as disease-related inflammation, morning stiffness, and fatigue intensity. The presence of changes in serum prolactin (PRL) was initially compared among the groups based on disease activity intensity. Using a multinomial regression analysis, the study analyzed the impact of predetermined clinical and metabolic factors on various categories of prolactin concentration.

RESULTS

Out of the 72 participants included in the study, hyperprolactinemia was detected in 9.1% of the sample. No differences in serum PRL were identified among the evaluated groups based on disease activity. Following multivariate analysis, no statistically significant differences were identified for the outcomes of inflammatory activity and morning stiffness within each PRL category when compared to the reference category for PRL. There was no increased likelihood of encountering blood glucose levels below 100 mg/dl among individuals with higher prolactin concentrations compared to those in the lowest prolactin category (OR 5.43, 95% CI 0.51-58.28). The presence of clinically significant fatigue revealed a higher likelihood of encountering this outcome among patients with intermediate PRL values (prolactin categories 7.76-10.35 with OR 5.18, 95% CI 1.01-26.38 and 10.36-15.29 with OR 6.25, 95% CI 1.2-32.51) when compared to the reference category.

CONCLUSIONS

The study found no discernible correlation between prolactin concentrations and worse scores for inflammatory activity of the disease, nor between prolactin concentrations and serum glucose levels. The findings regarding fatigue should be approached with caution given the exploratory nature of this study.

摘要

背景

在类风湿关节炎及其全身炎症的背景下,人们对催乳素在疾病的临床和代谢方面的作用越来越感兴趣。本研究旨在探讨血清催乳素水平、血糖水平与关节炎临床表现之间的潜在联系。

方法

这是一项探索性、横断面、观察性研究,研究对象为被诊断为类风湿关节炎的女性。研究涉及评估催乳素和血糖浓度,以及与疾病相关的炎症、晨僵和疲劳强度等特定临床特征。首先根据疾病活动强度比较各组之间血清催乳素(PRL)的变化。使用多项回归分析,研究分析了各种类别催乳素浓度的预定临床和代谢因素的影响。

结果

在纳入的 72 名参与者中,有 9.1%的样本存在高催乳素血症。根据疾病活动度评估,各组之间的血清 PRL 无差异。在多元分析后,与催乳素参考类别相比,在每个催乳素类别中,炎症活动度和晨僵的结果没有统计学意义。与催乳素浓度最低的类别相比,催乳素浓度较高的个体发生血糖水平低于 100mg/dl 的可能性没有增加(OR 5.43,95%CI 0.51-58.28)。存在临床显著疲劳的患者,催乳素值处于中间范围的患者更有可能出现这种结果(催乳素类别 7.76-10.35 的 OR 5.18,95%CI 1.01-26.38 和 10.36-15.29 的 OR 6.25,95%CI 1.2-32.51)与参考类别相比。

结论

本研究未发现催乳素浓度与疾病炎症活动度评分恶化之间存在明显相关性,也未发现催乳素浓度与血清葡萄糖水平之间存在相关性。鉴于本研究的探索性质,应谨慎对待疲劳方面的发现。

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