Patients with regular physical activity before onset of rheumatoid arthritis present with milder disease
Patients with regular physical activity before onset of rheumatoid arthritis present with milder disease
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DOI：
10.1136/annrheumdis-2014-205180
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发表时间：
2014-08-01
影响因子：
27.4
通讯作者：
Saevarsdottir, Saedis
中科院分区：
文献类型：
--
作者：
Sandberg, Maria E. C.;Wedren, Sara;Saevarsdottir, Saedis
体育活动已被证明可以减少炎症标志物；在这里，我们研究对类风湿关节炎（RA）临床表现的影响。方法采用基于人群的EIRA研究病例（N=617），随后纳入瑞典风湿病学质量登记册，计算诊断时28关节疾病活动评分（DAS28）、医生评估、疼痛（视觉模拟量表（VAS）、VAS-pain）和活动限制（健康评估问卷（HAQ））高于中位水平的几率，作为诊断前5年身体活动的影响，分类别和二分类进行调查。结果所有措施均存在剂量-反应关系；体力活动水平越高，结果高于中位数的可能性越低。此外，定期体育锻炼与DAS28高于中位数的几率降低42%相关（OR=0.58 (95% CI 0.42至0.81)）。VAS-pain （OR=0.62 (95% CI 0.45至0.86)）和医师评估（OR=0.67 (95% CI 0.47至0.95)）的效果相似，但HAQ的效果不同。DAS28的综合客观成分和综合主观成分均有显著的统计学意义。结论体力活动的个体似乎表现出较轻的RA，这增加了体力活动对炎症性疾病有益作用的证据。这一观察结果对卫生专业人员和寻求降低风险的个人都很重要。
Objectives Physical activity has been shown to decrease inflammatory markers; here we investigate the effect on the clinical presentation of rheumatoid arthritis (RA).Methods We used the cases from the population-based EIRA study (N=617), followed in the Swedish Rheumatology Quality Register, calculating the odds of having above median level of 28-joint disease activity score (DAS28), physician assessment, pain (visual-analogue scale (VAS), VAS-pain) and activity limitation (health assessment questionnaire (HAQ)) at diagnosis, as an effect of physical activity 5 years before diagnosis, investigated both in categories and dichotomised.Results Dose-response relationships were seen for all measures; the higher the level of physical activity, the lower the likelihood of having outcome measure above median. Further, regular physical activity associated with 42% reduced odds of having DAS28 above median (OR=0.58 (95% CI 0.42 to 0.81)). Effects were similar for VAS-pain (OR=0.62 (95% CI 0.45 to 0.86)) and physician assessment (OR=0.67 (95% CI 0.47 to 0.95)) but not for HAQ. Statistically significant effects were also found both for the combined objective components and the combined subjective components of DAS28.Conclusions Physically active individuals seem to present with milder RA, which adds to the evidence of beneficial effects of physical activity on inflammatory diseases. The observation should be important for both health professionals and individuals seeking to reduce their risk.