Turkish Journal of Physical Medicine and Rehabilitation 2002 , Vol 48 , Num 1

Romatoid Artritli Hastalarda Sistemik Tedavinin İdrar Glikosaminoglikan Atılımına Etkisi

Ayhan Bilgici 1 ,Ömer Kuru 1
1 Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Samsun, Türkiye

Objective: Since proteoglycan depletion is a marker of cartilage resorption, levels of glycosaminoglycan(GAG) in urine may provide a measure of ongoing cartilage degradation. The aim of this study was to investigate the relationship between urinary GAG excretion and systemic treatment in patients with RA.


Metods: Twenty four hour urine specimens were collected from 34 normal control and 34 patients with RA (according to American College of Rheumatology criteria). Twenty eight joints were assessed for articular index. RA patients were receiving nonsteroidal antiinflammatory drugs (NSAIDs), low dose steroids (<10mg/day), salazopyrin (SLZ) and methotrexate (MTX). Patients with significant renal or hepatic impairment were excluded. All urine sample were stored at -70?C before assayed. We used DMB (dimethylmethylene blue) dye binding assay to measure GAG excretion.


Results: Urinary GAG excretion were higher  in RA patients than normal controls (p<0.001). Patients treated with steroid without concomitant treatment with slow-acting antirheumatic drugs (SAARDs) had significantly lower GAG levels compared with patients who were taking NSAID’s (p<0.05). GAG levels were low in patients treated with SAARD than steroid treated group. No significant difference was found between SLZ and MTX treated groups.There was a statistically significant correlation between GAG levels with articular index (p<0.05).


Conclusion: This study shows that there is an increased urinary GAG excretion in patients with RA and falls after SAARD therapy but appears uninfluenced by treatment with NSAID’s.

Keywords : Rheumatoid arthritis, systemic therapy, glycosaminoglycan, articular cartilage