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Inflammatory anemia may be an indicator for predicting disease activity and structural damage in Chinese patients with rheumatoid arthritis

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Abstract

Objectives

This study aimed to investigate the relationship of serum hemoglobin (HB) level with disease activity and structural damage in Chinese patients with rheumatoid arthritis (RA).

Methods

A total of 890 RA patients and 890 normal subjects were enrolled in the case-control study. A HB threshold of< 110 g/L (women) and < 120 g/L (men) was used to determine anemia. All the patients were divided into three groups: non-anemia group (HB ≥ 120 g/L (male) or 110 g/L (female)), mild anemia group ((90 g/L < HB < lower limit of normal), and medium to severe anemia group (HB ≤ 90 g/L). Serum HB level and anemia prevalence between RA patients and normal subjects were compared. Associations of HB level with disease activity, structural damage, and function of joint in different groups were also investigated.

Results

The average of HB level in RA was (109.08 ± 17.96)g/l, which was lower than that in controls (136.75 ± 14.57)g/l (P < 0.001). Anemia was observed in 47% of the RA patients, while prevalence of anemia in control group was only 4.4%. In RA group, percentages of non-anemia, mild anemia, and medium to severe anemia were 47%, 38%, and 15%. Compared with non-anemia RA patients, RA patients with anemia had higher disease activity, severer structural damage and worse function of joint (P < 0.001). With the increase of anemia, the disease activity, structural damage, and dysfunction of joints increased significantly (P < 0.05–0.001). Linear regression analysis showed that HB level was negatively correlated with disease activity parameters, degree of joint destruction, and function (P < 0.05–0.001). Logistic regression indicated that serum HB level was protective factors for disease activity and structural damage in RA (P < 0.001).

Conclusion

HB level was significantly related to disease activity and structural damage in RA patients.

Key Points

• Inflammatory anemia was popular (about a half) in patients with RA.

• HB level was related to disease activity and structural damage in RA patients

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Acknowledgments

We thank all the patients for their enthusiastic participation in the study.

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, No.218, Ji-xi Road, Hefei, 230022, China

    Yang-fan Chen, Sheng-qian Xu, Wan-jun Li, Ke-ming Chen, Jing Cai & Mu Li

  2. Anhui Medical University, No.81, Mei-shan Road, Hefei, 230023, China

    Yue-chen Xu

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  1. Yang-fan Chen
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Correspondence to Sheng-qian Xu.

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Supplementary Fig S1

the distribution of anemia in RA patients. (A)Non-anemia group versus anemia group. (B)Non-anemia group versus mild anemia group versus medium to severe anemia group (JPG 52 kb)

Supplementary Fig. S2

Joint function in different RA patients. (A) Grade of joint function classification in different groups of anemia (P < 0.001), (B) Comparison of HAQ in different groups of anemia (P < 0.001) (JPG 150 kb)

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Chen, Yf., Xu, Sq., Xu, Yc. et al. Inflammatory anemia may be an indicator for predicting disease activity and structural damage in Chinese patients with rheumatoid arthritis. Clin Rheumatol 39, 1737–1745 (2020). https://doi.org/10.1007/s10067-019-04873-y

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  • DOI: https://doi.org/10.1007/s10067-019-04873-y

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