Abstract
Objective
The aim of this study is to determine the clinical characteristics of patients with rheumatoid arthritis (RA) sustaining high erythrocyte sedimentation rate (ESR) despite clinical remission.
Methods
This cross-sectional study involved 91 patients, who visited a tertiary medical center. Patients underwent laboratory tests and a physical examination by a rheumatologist. The disease activity score (DAS) was calculated and patients who were in remission (defined as DAS28-CRP <2.6) were selected. Patients were divided into two groups: those with high and low ESRs (≥40 and <40 mm/hr, respectively).
Results
DAS 28-CRP scores revealed that 61 of the 91 patients were in remission. Of these 61 patients, 15 and 46 were allocated to the high and low ESR groups, respectively. Compared to the low ESR group, the high ESR group had a longer disease duration (99.2±60.2 vs. 59.1±48.9 months), significantly higher white blood cell counts, and CRP levels, total modified Sharp radiographic joint scores, and erosion scores, as well as significantly lower hemoglobin, albumin and alanine aminotransferase levels.
References
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Table 1.
Low ESR (N=46) | High ESR (N=15) | p-value | |
---|---|---|---|
Age (years)∗ | 60.1±10.8 | 62.7±9.2 | NS |
M:F ratio | 12:34 | 4:11 | NS |
BMI (kg/m2) | 23.5±3.4 | 23.30±3.02 | NS |
Disease duration (months) | 59.1±49 | 99.2±60.2 | 0.023 |
Seropositive RA | 87% | 100% | NS |
Swelling joint count | 0.2±0.6 | 0.4±0.8 | NS |
Tenderness joint count | 0.3±0.6 | 0.4±0.6 | NS |
DAS28-ESR | 2.3±0.6 | 3.4±0.4 | 0.000 |
DAS28-CRP | 1.7±0.4 | 2.0±0.5 | 0.023 |
SDAI | 2.7±2.6 | 3.4±2.6 | NS |
CDAI | 2.4±2.6 | 2.6±2.3 | NS |
HAQ | 0.3±0.4 | 0.3±0.4 | NS |
Erosion score, 0∼160 scale∗ | 4.2±7.5 | 12.2±11.0 | 0.005 |
Joint space narrowing score, 0∼120 scale† | 5.0±8.6 | 8.6±10.1 | NS |
Total modified Sharp score, 0∼280 scale† | 9.3±15.1 | 20.7±19.0 | 0.012 |
Table 2.
Table 3.
Low ESR (N=46) | High ESR (N=15) | p-value | |
---|---|---|---|
White blood cell count (×103/μ L)∗ | 6.6±2.2 | 8.4±3.2 | 0.036 |
Hemoglobin (g/dL) | 12.9±1.3 | 12.1±1.3 | 0.046 |
Platelet count (×103/μ L) | 231.9±57.7 | 267.7±65.7 | NS |
ESR (mm/hr) | 20.6±12.7 | 71.1±18.4 | 0.000 |
CRP (mg/dL) | 0.3±0.3 | 0.7±0.8 | 0.001 |
Aspartate aminotransferase (IU/L) | 26.5±7.4 | 22.6±4.8 | NS |
Alanine aminotransferase (IU/L) | 21.0±8.6 | 15.4±3.7 | 0.004 |
Alkaline aminotransferase (IU/L) | 68.8±19.9 | 78.8±22.7 | NS |
Bilirubin (mg/dL) | 0.8±0.2 | 0.7±0.2 | NS |
Creatinine (mg/dL) | 0.8±0.2 | 0.8±0.2 | NS |
Uric acid (mg/dL) | 4.3±1.2 | 4.3±1.4 | NS |
Glucose (mg/dL) | 98.2±16.1 | 101.4±29.2 | NS |
Cholesterol (mg/dL) | 176.9±31.0 | 186.6±35.2 | NS |
Albumin (g/dL) | 4.1±.03 | 3.9±0.2 | 0.023 |
Protein (g/dL) | 7.0±0.7 | 7.3±0.5 | 0.035 |