School of Sport, Performing Arts & Leisure, Wolverhampton University, , Walsall, West Midlands, UK.
Ann Rheum Dis. 2014 Apr;73(4):748-51. doi: 10.1136/annrheumdis-2013-203291. Epub 2013 Jul 31.
We investigated the effects of individualised combined resistance and aerobic exercise on microvascular and macrovascular function in rheumatoid arthritis (RA) patients.
Forty age-matched, gender-matched and body mass index (BMI)-matched patients were allocated to either an exercise group, receiving a 6 months tailored aerobic and resistance exercise intervention, or controls receiving only information about the benefits of exercise. Participants were assessed for microvascular (acetylcholine (Ach) and sodium nitroprusside (SNP)) and macrovascular (flow-mediated dilatation (FMD) and glyceryl trinitrate (GTN)) endothelial function, maximal oxygen uptake, disease activity and severity (C-reactive protein (CRP), disease activity score 28 and health assessment questionnaire). Data were collected at baseline, 3 months and at the end of the intervention (6 months).
At baseline, demographic, anthropometric, disease-related characteristics and endothelial function parameters were similar between the exercise and control groups (p>0.05). Repeated measures analysis of variance revealed a significant improvement in endothelial function parameters at 3 (GTN: p<0.001) or 6 months (Ach: p=0.016, SNP: p=0.045, FMD: p=0.016) in the exercise but not in the control group. Generalised estimated equations detected that maximal oxygen uptake was a strong predictor for the observed changes in Ach (p=0.009) and GTN (p<0.001) whereas logCRP for SNP (p=0.017) and GTN (p=0.008).
An exercise programme designed to meet individual needs and physical abilities significantly improves microvascular and macrovascular function in parallel with disease-related characteristics in RA patients. The potential long-term beneficial effects of such interventions at reducing cardiovascular risk in these patients merit further exploration.
ISRCTN50861407.
我们研究了个体化联合抗阻和有氧运动对类风湿关节炎（RA）患者微血管和大血管功能的影响。
40 名年龄、性别和体重指数（BMI）匹配的患者被分配到运动组或对照组。运动组接受 6 个月的个体化有氧和抗阻运动干预，对照组仅接受运动益处的信息。评估参与者的微血管（乙酰胆碱（Ach）和硝普钠（SNP））和大血管（血流介导的扩张（FMD）和甘油三硝酸酯（GTN））内皮功能、最大摄氧量、疾病活动度和严重程度（C 反应蛋白（CRP）、28 个疾病活动评分和健康评估问卷）。数据在基线、3 个月和干预结束时（6 个月）收集。
在基线时，运动组和对照组的人口统计学、人体测量学、与疾病相关的特征和内皮功能参数相似（p>0.05）。重复测量方差分析显示，运动组内皮功能参数在 3 个月（GTN：p<0.001）或 6 个月（Ach：p=0.016，SNP：p=0.045，FMD：p=0.016）时显著改善，但对照组则无改善。广义估计方程检测到最大摄氧量是 Ach（p=0.009）和 GTN（p<0.001）观察到的变化的强预测因子，而 logCRP 是 SNP（p=0.017）和 GTN（p=0.008）的预测因子。
旨在满足个体需求和身体能力的运动方案可显著改善 RA 患者的微血管和大血管功能，并与疾病相关特征平行改善。这些干预措施在降低这些患者心血管风险方面的潜在长期有益效果值得进一步探索。
ISRCTN50861407。
