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 is being conducted at the NIH Clinical Center. In this investigation, we hypothesize 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 phase I of the study, RA patients and control subjects are 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 have initiated Phase I of the study to compare baseline endocrine and inflammatory parameters in RA patients with those in healthy, age- and BMI-matched women. Should the hypotheses in Phase I be satisfied, we plan to conduct a 2nd Phase of the study, in which we shall 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). To date, 7 RA patients and 10 matched control subjects have been evaluated; and enrollment for Phase I has been ended. Hormone, cytokine, body composition and other data are being tabulated and analysed in anticipation of manuscript preparation.

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
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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