Determinats of Body Composition in Rheumatoid Arthritis

描述（由申请人提供）：该指导以患者为导向的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者所需的技能和经验。为了实现这一目标，一个培训计划已经建立，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。由资深临床研究人员和与科学提案相关领域的公认专家组成的上级研究环境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性关节炎（RA）中身体成分改变的决定因素。在RA中，尽管体重保持不变，但瘦体重比非RA对照低10-15%。这一观察结果表明脂肪量净增加。然而，这一点尚未得到证实，也没有研究检查RA中脂肪和肌肉分布的区域模式。特别是，脂肪沉积模式，特别是位于腹腔的脂肪（内脏脂肪）已成为代谢综合征和心血管疾病的有力预测因素。此外，脂肪量的增加与瘦体重的净损失相结合，称为肌肉减少性肥胖，与非RA人群中的代谢综合征、心血管疾病和死亡率相关。这项建议的具体目标是：1.与匹配的非RA对照组相比，表征RA患者的身体组成并确定肌肉减少、肥胖和肌肉减少性肥胖的患病率2。描述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组分的患病率。3.确定与RA患者改变的身体组成表型、脂肪因子谱和胰岛素抵抗相关的炎症和非炎症因子。

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 .