This is a study in pre-menopausal women with onset of rheumatoid arthritis (RA) of less than 3 years duration, to be conducted at the NIH Clinical Center and The General Clinical Research Center of the Johns Hopkins Bayview Medical Center, Baltimore, MD. This investigation will explore the possible impact of systemically released inflammatory cytokines on suppression of the GH/IGF-1 axis, and the relationships of altered endocrine-immune function with body composition, endocrine, metabolic and vascular functions thought to be associated with RA-related sarcopenia, osteopenia and increased cardiovascular risk. In phase I of the study, we shall admit RA patients and control subjects 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 plan to initiate Phase I of the study to compare baseline endocrine and inflammatory parameters in RA patients to matched normal controls. Phase II of the study, we shall enroll a new group of RA patients to evaluate the above outcome measures at baseline and after six months of treatment with standard therapy, using the soluble p75 TNF receptor molecule etanercept, that has recently been approved by the FDA for the treatment of patients with early RA. Phase 2 of this study will be initiated upon access to etanercept and completion of Phase I of the study.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Intramural Research (Z01)
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Complementary & Alternative Medicine
United States
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Blackman, Marc R; Muniyappa, Ranganath; Wilson, Mildred et al. (2007) Diurnal secretion of growth hormone, cortisol, and dehydroepiandrosterone in pre- and perimenopausal women with active rheumatoid arthritis: a pilot case-control study. Arthritis Res Ther 9:R73
Muniyappa, Ranganath; Wong, Kelli A; Baldwin, Howard L et al. (2006) Dehydroepiandrosterone secretion in healthy older men and women: effects of testosterone and growth hormone administration in older men. J Clin Endocrinol Metab 91:4445-52
Munzer, Thomas; Rosen, Clifford J; Harman, S Mitchell et al. (2006) Effects of GH and/or sex steroids on circulating IGF-I and IGFBPs in healthy, aged women and men. Am J Physiol Endocrinol Metab 290:E1006-13
Hougaku, Hidetaka; Fleg, Jerome L; Najjar, Samer S et al. (2006) Relationship between androgenic hormones and arterial stiffness, based on longitudinal hormone measurements. Am J Physiol Endocrinol Metab 290:E234-42
Huang, Xin; Blackman, Marc R; Herreman, Karen et al. (2005) Effects of growth hormone and/or sex steroid administration on whole-body protein turnover in healthy aged women and men. Metabolism 54:1162-7
Roy, Tracey Ann; Blackman, Marc R; Harman, S Mitchell et al. (2002) Interrelationships of serum testosterone and free testosterone index with FFM and strength in aging men. Am J Physiol Endocrinol Metab 283:E284-94