Rall L C, Rosen C J, Dolnikowski G, Hartman W J, Lundgren N, Abad L W, Dinarello C A, Roubenoff R
USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts 02111, USA.
Arthritis Rheum. 1996 Jul;39(7):1115-24. doi: 10.1002/art.1780390707.
To determine the effects of rheumatoid arthritis (RA) on whole-body protein metabolism.
We examined protein metabolism and its hormonal and cytokine mediators before and 12 weeks after progressive resistance muscle strength training in 8 healthy young (mean +/- SD age 25 +/- 2 years) and 8 healthy elderly (70 +/- 5 years) men and women, and in 8 adults with RA (42 +/- 13 years). An additional 6 healthy elderly subjects (69 +/- 3 years) served as a swimming-only control group.
Subjects with RA had higher rates of protein breakdown than did young or elderly healthy subjects (79.9 +/- 17.2 versus 60.3 +/- 5.8 and 63.7 +/- 12.4 mumoles/gm total body potassium/hour, respectively, P < 0.05), while there was no effect of age per se. Patients treated with methotrexate had normal rates of protein breakdown (P < 0.01 versus RA without methotrexate; P not significant versus healthy young subjects). Increased protein catabolism in RA was no longer evident after strength training. In multiple regression analysis, levels of tumor necrosis factor alpha (TNF alpha) (r = 0.47, P = 0.01) and growth hormone (r = -0.51, P = 0.006) were associated with protein breakdown, and plasma glucagon levels were inversely correlated with protein synthesis (r = -0.45, P = 0.02). Growth hormone (r = -0.56, P = 0.002) and glucagon (r = 0.45, P = 0.04, levels were associated with protein oxidation.
Adults with RA have increased whole-body protein breakdown, which correlates with growth hormone, glucagon, and TNF alpha production.
确定类风湿关节炎（RA）对全身蛋白质代谢的影响。
我们检测了8名健康青年（平均±标准差年龄25±2岁）、8名健康老年（70±5岁）男性和女性，以及8名成年RA患者（42±13岁）在进行渐进性抗阻肌肉力量训练前及训练12周后的蛋白质代谢及其激素和细胞因子介质。另外6名健康老年受试者（69±3岁）作为仅进行游泳的对照组。
RA患者的蛋白质分解率高于健康青年或老年受试者（分别为79.9±17.2与60.3±5.8和63.7±12.4微摩尔/克全身钾/小时，P<0.05），而年龄本身并无影响。接受甲氨蝶呤治疗的患者蛋白质分解率正常（与未使用甲氨蝶呤的RA患者相比，P<0.01；与健康青年受试者相比，P无统计学意义）。力量训练后，RA中增加的蛋白质分解代谢不再明显。在多元回归分析中，肿瘤坏死因子α（TNFα）水平（r=0.47，P=0.01）和生长激素（r=-0.51，P=0.006）与蛋白质分解相关，血浆胰高血糖素水平与蛋白质合成呈负相关（r=-0.45，P=0.02）。生长激素（r=-0.56，P=0.002）和胰高血糖素（r=0.45，P=0.04）水平与蛋白质氧化相关。
成年RA患者全身蛋白质分解增加，这与生长激素、胰高血糖素和TNFα的产生相关。
