The relation between prolactin values and the degree of functional disability assessed by a HAQ questionnaire in patients with rheumatoid arthritis

Czech version

Authors: Ž. Macejová ¹; I. Nagyová ²; D. Trejbal ³; I. Lazúrová ¹
Authors‘ workplace: I. interná klinika Lekárskej fakulty UPJŠ a FN L. Pasteura, Košice, Slovenská republika, prednosta prof. MUDr. Ivica Lazúrová, CSc. ¹; Ústav humanitných vied Prírodovedeckej fakulty UPJŠ, Košice, Slovenská republika ²; IV. interná klinika Lekárskej fakulty UPJŠ a FN L. Pasteura, Košice, Slovenská republika prednosta prof. MUDr. Ivan Tkáč, CSc. ³
Published in: Vnitř Lék 2005; 51(11): 1260-1265
Category: Original Contributions

Overview

Rheumatoid arthritis (RA) is a chronic inflammatory disease of joints the ethiopathogenesis of which is still uncertain. The finding that prolactin (PRL) has an influence on immunity has lead to assumptions that it may interfere with RA ethiopathogenesis. The consequences of RA consist in the destruction of joint cartilage and the adjacent bone, which causes pain and restricts the function of the affected joint. The objective of the study was to examine basally stimulated prolactin values in patients with RA in order to identify the relation between prolactin levels, inflammation markers and the patient's functional condition.

Set and methods:
The authors examined 40 patients of which 31 women aged on average 46.6 years, and 9 men, aged on average 34.7 years. A verification set of 30 volunteers was examined, aged on average 35.17 years. Prolactin levels were measured by chemiluminiscent method – immunochemical response with monoclonal antibody – using the Imunolite device. The authors evaluated the patient’s functional condition using the Stanford questionnaire for health condition assessment, applying the disability index (HAQ).

Results:
PRL values for patients with RA were higher (10.9 ng/ml) as compared with healthy population (6.9 ng/ml), without statistical significance. However, after i. v. stimulation of TRH a statistically significant increase in PRL was recorded – 20 minutes after 58.4 ng/ml stimulation and 60 minutes after 32.5 ng/ml stimulation in patients with RA, and 20 minutes after 30.9 ng/ml, and 60 minutes after 16.4 ng/ml stimulation in the verification group. A positive correlation was detected between the PRL values and the rate of functional disability assessed by the HAQ questionnaire.

Conclusion:
The study showed that hyperprolactinemia is linked with a higher rate of functional disability assessed by the HAQ questionnaire. There are two possible explanations for the positive correlation between PRL levels and the rate of functional disability. Hyperprolactinemia is often associated with depressive mood symptoms of the patient, which may also be reflected in the patient's answers filled in the functional disability questionnaire (HAQ). At the same time, this may mean that the functional disability is a stress factor for the patient and that it may be the patient proper to cause the hyperprolactinemic condition.

Key words:
rheumatoid arthritis – prolactin – functional disability – HAQ

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