Tolerance to complex load in patients with rheumatoid arthritis, gout, and fibromyalgia: a crosssectional study

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Abstract

BACKGROUND: Rheumatoid arthritis, gout, and fibromyalgia are common diseases; however, data on tolerance to psychomotor, intellectual, and communicative load in these patient groups are limited.

AIM: This study aimed to conduct a comparative analysis of the regulatory systems stress index, as well as hormonal and immunological serum parameters, in patients with rheumatoid arthritis, gout, and fibromyalgia under complex load conditions.

METHODS: The study included 21 patients with rheumatoid arthritis, 23 patients with gout, and 12 patients with fibromyalgia (age range 20–54 years). Diagnoses were established according to generally accepted criteria. The complex load lasted 4 hours and consisted of sequential psychomotor, intellectual, and communicative tasks. Load tolerance was assessed based on task performance, as well as on hormonal (cortisol, epinephrine, norepinephrine, serotonin, dopamine) and immunological (interleukin4, interleukin6, interleukin10, tumor necrosis factor) serum levels, and heart rate variability parameters. Statistical analysis was performed using general linear modeling (GLM, multivariate test), Wilcoxon W test, Mann–Whitney U test, Kruskal–Wallis H test, and Spearman rank correlation coefficient.

RESULTS: Patients with rheumatoid arthritis tolerated physical, intellectual, and communicative load satisfactorily (SI: 98.87, 91.07, and 95.01 arbitrary units, respectively). Patients with gout showed better tolerance of communicative load (SI = 116.46) compared with physical (SI = 139.36) and intellectual (SI = 171.61) loads. Patients with fibromyalgia tolerated prolonged complex load poorly, which caused overstrain of regulatory systems during physical (SI = 321.28), intellectual (SI = 400.95), and communicative (SI = 166.23) tasks. After complex load, a significant increase in serum interleukin4 levels was observed in men with rheumatoid arthritis (from 24.32 to 33.3 pg/mL; p = 0.023) and in men with gout (from 11.26 to 17.87 pg/mL; p = 0.007), as well as a decrease in interleukin10 levels in women with fibromyalgia (from 5.93 to 5.25 pg/mL; p = 0.035).

CONCLUSION: Differences were identified in the regulatory systems stress index during physical, intellectual, and communicative loads, as well as in the dynamics of hormonal and immunological serum parameters, in patients with rheumatoid arthritis, gout, and fibromyalgia.

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About the authors

Elena V. Volkova

Institute of Psychology of the Russian Academy of Sciences

Email: volkovaeva@ipran.ru
ORCID iD: 0000-0003-3809-3639
SPIN-code: 8375-5018

Dr. Sci. (Psychology), Assistant Professor

Russian Federation, Moscow

Olga V. Teplyakova

Ural State Medical University

Email: oteplyakova69@gmail.com
ORCID iD: 0000-0003-2114-0419
SPIN-code: 3208-8679

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Yekaterinburg

Irina O. Kuvaeva

Institute of Psychology of the Russian Academy of Sciences; Ural Federal University named after the first President of Russia B.N. Yeltsin

Author for correspondence.
Email: irina.kuvaeva@urfu.ru
ORCID iD: 0000-0001-5451-0725
SPIN-code: 7244-9678

Cand. Sci. (Psychology;

Russian Federation, Moscow; 19 Mira st, Ekaterinburg, 620002

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2. Fig. 1. Intergroup differences in changes in serum hormone levels before and after complex load in patients with rheumatoid arthritis (РА), gout (ПА), and fibromyalgia (ФМ): (а) serotonin, (b) cortisol, (c) norepinephrine, (d) epinephrine, and (e) dopamine.

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