INFLUENCE OF HEMOGLOBIN LEVELS, ERYTHROCYTE SEDIMENTATION RATE AND C-REACTIVE PROTEIN ON THE HEALTH-RELATED QUALITY OF LIFE OF RHEUMATOID ARTHRITIS PATIENTS
Keywords:
rheumatoid arthritis, health-related quality of life, CRP, ESRAbstract
The association between laboratory parameters and health-related quality of life (HRQoL) among general population has been previously explored. However, limited data are available for rheumatoid arthritis (RA) patients. The aim of the present study is to explore how hemoglobin levels and inflammatory markers (erythrocyte sedimentation rate and C-reactive protein) influence HRQoL of RA patients. Materials and Methods: A total of 179 RA patients have been treated at two hospitals (Military Medical Academy UMHAT Sofia and UMHAT “Kaspela” EAD, Plovdiv) between October 2014 and May 2017. The patient data were retrospectively collected. ESR, CRP, WBC, and Hb were tested at baseline, 6, 12, and 24 months after treatment initiation as routine disease activity (DA) measures. Eights domains of SF-36 were calculated to assess HRQoL as well as visual-analogue scales (VAS) for DA assessed by the patient, and the physician. To assess the correlation between laboratory parameters and domains of HRQoL, Spearman’s rank correlation coefficient (ρ) was used. Results: At baseline ESR showed a positive correlation (increased ESR and high DA) to VAS DA measured both by patients and physicians, and its strength increases with the time. Moreover, a negative correlation to SF-36 domains was observed at 12 and 24 months follow-up: the increased ESR was related to lower HRQoL. Similarly, CRP showed positive correlation to VAS DA measured both by patients and physicians at baseline with increased strength at 24 months follow-up, as well as negative associations to all SF-36 domains. Hemoglobin was negatively related only to VAS measured by the physicians and with the increase of treatment duration more correlations were observed: positive associations to SF-36 domains (higher Hb levels and higher HRQoL). Conclusion: The explored laboratory parameters are related to HRQoL. The strength of the relationships increases during treatment and is strongest after 24 months of its initiation.
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