A Hospital Based Case Control Study on Serum Prolactin Levels and Its Correlation with Anti CCP Levels in Recently Diagnosed Rheumatoid Arthritis in Chennai, Tamil Nadu

Abstract

Karthiga Murugan1, Dania Tamilselvi Tamilselvan2, Ananthan Veeranan3

BACKGROUND

Prolactin, an anterior pituitary hormone, exhibits immunoregulatory properties. It up regulates Th1 cytokines expression; that plays a crucial role in autoimmune disorders. In autoimmune diseases like rheumatoid arthritis (RA), altered serum prolactin level causes exacerbation. Hence, administration of drugs like bromocriptine, cabergoline in rheumatoid arthritis patients with elevated serum prolactin cause disease remission. In RA patient, an antibody by name ACPA - Anti citrullinated protein antibodies are released which binds with citrullinated proteins. Anti cyclic citrullinated peptides (Anti-CCP) is 90 % specific for rheumatoid arthritis. Hence, this study was done to determine the status of serum prolactin and correlate serum prolactin with anti CCP in recently diagnosed rheumatoid arthritis patients.

METHODS

Serum prolactin and anti-cyclic citrullinated peptide antibody levels were measured using enzyme linked immunosorbent assay (ELISA) technique in 55 recently diagnosed rheumatoid arthritis patients, compared with 27 age and sex matched apparently healthy controls. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 20. Tests of significance using unpaired student’s t-test at 5 % significance was used to compare the serum prolactin between cases and controls. Pearson’s correlation co-efficient to measure the linear relation between serum prolactin concentration and anti CCP were carried out.

RESULTS

87 % of study population was females, with majority in the age group of 31 to 40 years. The mean serum prolactin concentration in cases was 33.531 ± 17.92 ng/mL and in controls was 14.4 ± 5.9 ng/mL. The 95 % confidence interval for mean of serum prolactin concentration in cases were 50.84 to 16.22 ng/mL, controls were 22.54 to 6.26 ng/mL. The p value was significant, less than 0.001. Pearson correlation between prolactin and anti CCP had no significance; p – value 0.760.

CONCLUSIONS

Serum prolactin concentration in rheumatoid arthritis patients was higher. These results identify the use of dopamine agonist as an adjuvant treatment in remission of rheumatoid arthritis. There was no correlation between serum prolactin and anti CCP levels among RA patients.

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