Suppression of the GH/IGF-I Axis In Women With Rheumatoi

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This is a study in pre- and peri-menopausal women with onset of rheumatoid arthritis (RA) of less than 3 years duration, and active, inflammatory disease, that was conducted at the NIH Clinical Center. In this investigation, we hypothesized that the excess of systemically released inflammatory cytokines in RA patients suppresses activity of the GH/IGF-1 axis, and that the combined effects of disordered endocrine-immune function contribute to changes in body composition, endocrine-metabolic and vascular functions thought predisposing to RA-related sarcopenia, osteopenia and increased cardiovascular risk. In this study, RA patients and control subjects were admitted to the Clinical Center for a 36 hour period for assessments of the GH/IGF-I axis, cytokines, body composition, endocrine- metabolic and cardiovascular functions, and quality of life. We conducted this study to compare baseline endocrine and inflammatory parameters in RA patients with those in healthy, age- and BMI-matched women. Should the hypotheses be satisfied, we shall consider conducting a follow-up study, in which we would enroll a similar group of RA patients to evaluate the above outcome measures at baseline and after six months of treatment with one of the available TNF-alpha receptor antagonists, both in the absence and presence of DHEA or other CAM intervention (e.g. meditation). We evaluated a total of 7 RA patients and 10 matched control subjects; and enrollment has been ended, and the study terminated. Since the last report, we have measured 24 hour DHEA and cytokine secretion, the latter using a mulitplex assay system. Hormone, body composition and other data have been tabulated and analysed and a manuscript is in preparation. Cytokine data have been tabulated and are currently being analysed in anticipation of preparaing a second manuscript.