Patient Reported Physical Capacity Correlates with Phenylalanine Serum Levels in Patients with Early Untreated Rheumatoid Arthritis

Aulikki Kononoff¹, Leena Arstila^1,2, Hannu Kautiainen^3,4, Pia Elfving¹, Elina Savolainen⁵, Helena Niinisalo^6,7 and Oili Kaipiainen-Seppanen¹, ¹Department of Medicine, Kuopio University Hospital, Kuopio, Finland, ²Iisalmi Hospital, Iisalmi, Finland, ³Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland, ⁴Unit of Primary Health Care, Helsinki University Central Hospital, Helsinki, Finland, ⁵Kuopio Municipal Hospital, Kuopio, Finland, ⁶Suonenjoki Health Center, Suonenjoki, Finland, ⁷Varkaus Hospital, Varkaus, Finland

Meeting: ACR/ARHP Annual Meeting 2015

Date of first publication: September 29, 2015

Keywords: Health Assessment Questionnaire, Inflammation, pain, patient outcomes and rheumatoid arthritis (RA)

Session Information

Date: Tuesday, November 10, 2015

Title: Rheumatoid Arthritis - Clinical Aspects Poster Session III

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Lipolysis is increased in rheumatoid arthritis (RA), and lipid-induced insulin resistance coincides with anabolic resistance. Ability to maintain skeletal muscle mass is impaired in insulin-resistant conditions. Low grade inflammation prevents protein synthesis in peripheral muscles. Phenylalanine is associated with whole body protein turnover; protein synthesis and break down.We have investigated the relationship between amino acids and patient reported outcomes: general health (GH, patient global estimate, VAS), pain (VAS) and HAQ, among patients with newly diagnosed RA in a population based cohort.

Methods:

For quantification of amino acids and alpha-1-acyl glycoprotein (GP) levels serum nuclear magnetic resonance platform operating at 500 MHz was used in native serum samples from patients with RA participating in Northern Savo 2010 Study. Crude, age and BMI adjusted correlations between HAQ, phenylalanine, and inflammatory parameters were counted.

Results:

Serum samples from 63 patients, 34 females and 29 males with RA satisfying the ACR/Eular 2010 classification criteria, were studied. The mean age (SD) of the patients was 59.1 (12.0) years and the mean BMI 27.3 (5.4) kg/m². 69.8 % had anti-CCP antibodies. The mean DAS28(ESR) was 4.4 (1.3), GH 52.7 (25.7), pain 56.4 (29.1), HAQ 0.70 (0.65), and GP 1.62 (0.29) mmol/L. DAS28(ESR) correlated with HAQ 0.41 (0.18 to 0.59), p < 0.01, with ESR 0.36 (0.12 to 0.56), p < 0.05, GH 0.38 (0.13 to 0.57), p<0.05, and physical function (HAQ) 0.61 (0.43 to 0.75), p< 0.001. HAQ-levels increased with increasing phenylalanine serum levels, adjusted for age, gender, BMI, duration of symptoms, tender joint count, swollen joint count, Charlson comorbidity index score, GP level and seropositivity, p for linearity = 0.029.

Conclusion:

Patient reported physical function correlates with phenylalanine serum levels in untreated RA. The result reflects changes in muscle metabolism in RA, in which inflammation induces protein break down and prevents protein synthesis in peripheral muscles.

Disclosure: A. Kononoff, None; L. Arstila, None; H. Kautiainen, None; P. Elfving, None; E. Savolainen, None; H. Niinisalo, None; O. Kaipiainen-Seppanen, None.

To cite this abstract in AMA style:

Kononoff A, Arstila L, Kautiainen H, Elfving P, Savolainen E, Niinisalo H, Kaipiainen-Seppanen O. Patient Reported Physical Capacity Correlates with Phenylalanine Serum Levels in Patients with Early Untreated Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/patient-reported-physical-capacity-correlates-with-phenylalanine-serum-levels-in-patients-with-early-untreated-rheumatoid-arthritis/. Accessed .

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