A Cross-sectional Study on Grip Ability Test and its Relation with “Hy” Band: Surrogate Marker for Amyloidosis in Patients with Rheumatoid Arthritis

Abstract

Introduction: Rheumatoid Arthritis (RA) is a chronic inflammatory disease of autoimmune origin. The disease has specific predilection for small joints of the body especially joints of the hand. Thus, by evaluating the hand grip ability, we can measure the severity of RA. The “Hy” band occurs due to an increase in prealbumin as shown by Serum protein electrophoresis. Few studies on Prealbumin show that increased prealbumin is directly associated with Amyloidosis. Amyloidosis being a known complication of RA drew attention towards “Hy” band. Aim: To establish Grip Ability Test (GAT) as a predictor of RA severity and find its correlation with presence of “Hy” band. Materials and Methods: This cross-sectional study was conducted at Government Villupuram Medical College, Tamilnadu, India. The study included 20 RA patients diagnosed by ARA/EULAR 2010 criteria, recruited from the Department of Orthopaedics. After due ethical clearance, all demographic data, DAS28 score, ESR, Duruoz Hand Index were obtained. GAT was performed using Handgrip Dynamometer. “Hy” band was detected by Serum electrophoresis using automated capillary zone electrophoresis. The values were pooled and statistical analysis was performed using epi info version 7.2.2 p-value <0.05 was considered significant. Results: There was a statistically significant correlation between GAT and disease activity (p=0.001). Statistical significance for correlation between “Hy” band and GAT values was dull (p=0.7279 in dominant hand and 0.3337 in non-dominant hand). Conclusion: GAT shows significant correlation with disease activity. Hence, GAT will serve as a reliable and objective method of measuring disease severity in RA. GAT may be used as a clinically simple performance based prognostic tool. The presence of “Hy” band shows no correlation with GAT scores.

Keywords

• disease activity score
• hand strength
• prognosis
• rheumatology
• serum electrophoresis
• transthyretin