Objective: To examine the relationship between inflammatory cytokine production and body cell mass (BCM) in women with stable, medically well-controlled rheumatoid arthritis (RA).
Methods: Case-control study of 20 women with RA and 20 healthy women matched for age, race, and body mass index (kg/m2). Tumor necrosis factor-alpha (TNF-alpha), interleukin 1beta (IL-1beta), and IL-6 production were measured by specific, non-cross-reacting ELISA of peripheral blood mononuclear cells (PBMC) cultured with and without 100 ng/ml of endotoxin. Total BCM was assessed by the reference method of whole-body counting of naturally occurring radioactive potassium-40.
Results: Patients with RA were cachectic, with 14% less BCM (p < 0.001) and higher TNF-alpha production (p < 0.05) than controls. TNF-alpha production was inversely associated with BCM both without (r = -0.51, p = 0.03) and with (r = -0.57, p = 0.01) endotoxin stimulation in patients but not in controls. In multivariate linear regression models, these inverse associations remained significant after adjustment for age and physical activity. No association was found for IL-1beta or IL-6 production in these models.
Conclusion: Women with stable, medically well-controlled RA have lower than normal BCM that is inversely associated with elevated TNF-alpha production.