Cinical
& Laboratory Indices of Rheumatoid Activity:
Correlation Analysis
ANURADHA VENUGOPALAN,
ARVIND CHOPRA, GORE A
MEDINOVA– HERMES DOCTOR HOUSE & PUNE UNIVERSITY,
PUNE 411 001.
Journal of Indian Rheumatism Association. 1995 Vol :
3 (4): Sup 4
Introduction
182 patients (mean age 45 years, 152 females) with active
rheumatoid arthritis (RA), belonging to ARA Class I-III
were evaluated in detail for clinical and laboratory
indices of disease activity. 149 patients were seropositive
for RF. The American College of Rheumatology publication
on disease activity measures (Arth Rheum 36:729-740,
1993) served as a guide to this study. The joint counts
for pain and tenderness (JCPT) and swelling (JCSW) have
been selected for correlation with ESR (Westergren),
haemoglobin (Hb gm/dL), C – Reactive protein (CRP)
and interleukin-6 (IL-6). CRP was estimated by nephlometry
(Beckman ICS). A cell based bio-assay was used to measure
IL-6 with a sensitivity range of 0.1-500 u/dL. The correlation
matrix between these parameters, using standard statistical
methods, is as follows:
JCPT
JCSW
ESR
Hb
CRP
JCSW
0.587
ESR
0.128
0.167
Hb
-0.162
-0.230
-0.356
CRP
0.048
0.136
0.242
-0.150
IL-6
-0.089
-0.100
0.010
-0.004
-0.091
Conclusion
Hb seems most strongly correlated
with JCSW, JCPT and ESR. This correlation is negative.
ESR & CRP correlate
positively with each other and clinical indices;
ESR performs better. 3. IL-6 does not appear to
bear any significant correlation with other clinical
or laboratory indices
Remarks
That Hb, despite, it’s mutifactorial aetiopathogenesis
in RA, should have better correlation than ESR/CRP with
chosen clinical measures of disease activity deserves
a special mention in the Indian context. Surprisingly,
IL-6, a biologic proxy of inflammation does not appear
to perform well as a measure of disease activity.
CENTER
FOR RHEUMATIC DISEASES (CRD)
Hermes Doctor House, Hermes Elegance,
Convent Street, Camp, Pune – 411 001, Maharashtra, India.
Tel: 020-26348529, 26345624, 26344099
