Determinats of Body Composition in Rheumatoid Arthritis

描述(由申请者提供)：这个以患者为导向的指导职业发展奖的主要目标是发展成为一名成功的独立临床研究员所需的技能和经验。为了实现这一目标，已经建立了一个培训计划，以促进：1.流行病学、生物统计学和临床试验设计方法的高级培训2.由高级临床研究人员和与科学提案相关领域的公认专家组成的优越研究环境3.建立未来研究项目和合作的基础本提案的科学目标是探索类风湿关节炎(RA)身体成分改变的决定因素。类风湿性关节炎患者的瘦体重比非类风湿性关节炎对照组低10-15%，尽管保持了体重。这一观察结果表明，脂肪质量出现了净增长。然而，这一点尚未得到证实，也没有研究检查类风湿关节炎脂肪和肌肉分布的区域模式。特别是，脂肪沉积的模式，特别是定位于腹部的脂肪(内脏脂肪)已成为代谢综合征和心血管疾病的有效预测因子。此外，在非类风湿关节炎人群中，脂肪质量的增加和瘦体重的净减少(称为骨质疏松性肥胖)与代谢综合征、心血管疾病和死亡率有关。这项建议的具体目的是：1.确定RA患者与匹配的非RA对照组相比的身体成分、肥胖症和骨骼肥胖症的患病率；2.确定RA患者与匹配的非RA对照组相比的血清脂肪因子谱、胰岛素抵抗和代谢综合征的患病率。3.确定与RA患者的身体成分表型、脂肪因子谱和胰岛素抵抗相关的炎性和非炎性因子。

DESCRIPTION (provided by applicant): The primary objective of this Mentored Patient-Oriented Career Development Award is to develop the skills and experience required to become a successful independent clinical investigator. In order to attain this objective, a training program has been constructed to foster: 1. Advanced training in the methods of epidemiology, biostatistics, and clinical trial design 2. A superior research environment made up of senior clinical investigators and well recognized experts in fields related to the scientific proposal 3. The groundwork on which to build future research projects and collaborations The scientific objective of this proposal is to explore the determinants of altered body composition in rheumatoid arthritis (RA). In RA, lean body mass is 10-15% lower than in non-RA controls despite the preservation of body weight. This observation suggests a net gain in fat mass. This has not been confirmed, however, and no studies have examined regional patterns of fat and muscle distribution in RA. In particular, patterns of fat deposition, particularly fat localized to the abdominal cavity (visceral fat) has emerged as a potent predictor of metabolic syndrome and cardiovascular disease. Further, an increase in fat mass combined with a net loss in lean body mass, termed sarcopenic obesity, has been associated with metabolic syndrome, cardiovascular disease, and mortality in non-RA populations. The specific aims of this proposal are to: 1. Characterize body composition and identify the prevalence of sarcopenic, obesity, and sarcopenic obesity in patients with RA compared to matched non-RA controls 2. Characterize serum adipokine profiles, insulin resistance, and the prevalence of components of the metabolic syndrome in patients with RA compared to matched non-RA controls. 3. Identify the inflammatory and non-inflammatory factors associated with altered body composition phenotypes, adipokine profiles, and insulin resistance in patients with RA .