Froidure Sarah, Kyheng Maeva, Grosbois Jean Marie, Lhuissier Francois, Stelianides Sandrine, Wemeau Lidwine, Wallaert Benoit
Service de Pneumologie et ImmunoAllergologie, Centre de compétence des maladies rares and Univ. Lille CHU Lille Lille France.
Department of Biostatistics CHU Lille Lille France.
Health Sci Rep. 2019 Jan 15;2(2):e109. doi: 10.1002/hsr2.109. eCollection 2019 Feb.
Little is known about the consequences of chronic sarcoidosis on daily life physical activity (DL). The aim of this prospective study was to measure DL in patients with chronic sarcoidosis and to determine its relationship to clinical and functional parameters.
Fifty-three patients with chronic sarcoidosis and 28 healthy control subjects were enrolled in this multicenter prospective study. Two markers of DL (number of steps walked per day [SPD]) and total daily energy expenditure (TEE) were assessed for five consecutive days with a physical activity monitor. Pulmonary function, aerobic capacity (maximal oxygen uptake [VOmax]), exercise capacity (6-min walk test [6MWT]), and quality of life (self-reported questionnaires) were also evaluated. Comparisons of DL parameters between the two groups were performed using an analysis of covariance adjusted for age, sex, and body mass index (BMI). Relationships between DL parameters and patient characteristics were assessed in multivariable linear regression models.
Patients with sarcoidosis walked significantly fewer SPD than did the control subjects (6395 ± 4119 and 11 817 ± 3600, respectively; < 0.001 after adjustment for age, BMI, and sex). TEE was not significantly different between patients with sarcoidosis and healthy controls (median [interquartile range]: 2369 [2004-2827] and 2387 [2319-2876] kcal/day, respectively, = 0.054 adjusted for age, BMI, and sex). SPD showed significant positive correlations with 6MWT distance (Pearson's correlation, = 0.32, 95% confidence intervals [95%CI] = 0.06, 0.55; = 0.019), VOmax ( = 0.44, 95%CI = 0.17, 0.65; = 0.002), and Visual Simplified Respiratory Questionnaire score ( = 0.44, 95%CI = 0.19, 0.64; = 0.001), and a significant negative correlation with modified Medical Research Council questionnaire score ( = -0.38, 95%CI = -0.60, -0.10; = 0.009). TEE was significantly correlated with BMI ( = 0.38, 95%CI = 0.13, 0.59; = 0.004), forced expiratory volume in 1 second ( = 0.55, 95%CI = 0.33, 0.71; < 0.001), total lung capacity ( = 0.44, 95%CI = 0.18, 0.64; = 0.001), and forced vital capacity ( = 0.56, 95%CI = 0.34, 0.72; < 0.001). In multivariable analysis, SPD remained associated only with VOmax.
Patients with chronic sarcoidosis appear to have reduced DL mainly because of compromised VOmax.
关于慢性结节病对日常生活身体活动（DL）的影响，人们了解甚少。这项前瞻性研究的目的是测量慢性结节病患者的DL，并确定其与临床和功能参数之间的关系。
本多中心前瞻性研究纳入了53例慢性结节病患者和28名健康对照者。使用身体活动监测仪连续五天评估DL的两个指标（每日步数[SPD]）和每日总能量消耗（TEE）。还评估了肺功能、有氧运动能力（最大摄氧量[VOmax]）、运动能力（6分钟步行试验[6MWT]）和生活质量（自我报告问卷）。两组之间DL参数的比较采用协方差分析，并对年龄、性别和体重指数（BMI）进行了校正。在多变量线性回归模型中评估DL参数与患者特征之间的关系。
结节病患者的SPD明显少于对照组（分别为6395±4119步和11817±3600步；校正年龄、BMI和性别后P<0.001）。结节病患者与健康对照者的TEE无显著差异（中位数[四分位间距]：分别为2369[2004-2827]千卡/天和2387[2319-2876]千卡/天，校正年龄、BMI和性别后P=0.054）。SPD与6MWT距离（Pearson相关系数，P=0.32，95%置信区间[95%CI]=0.06，0.55；P=0.019）、VOmax（P=0.44，95%CI=0.17，0.65；P=0.002）和视觉简化呼吸问卷评分（P=0.44，95%CI=0.19，0.64；P=0.001）呈显著正相关，与改良医学研究委员会问卷评分呈显著负相关（P=-0.38，95%CI=-0.60，-0.10；P=0.009）。TEE与BMI（P=0.38，95%CI=0.13，0.59；P=0.004）、第1秒用力呼气量（P=0.55，95%CI=0.33，0.71；P<0.001）、肺总量（P=0.44，95%CI=0.18，0.64；P=0.001）和用力肺活量（P=0.56，95%CI=0.34，0.72；P<0.001）显著相关。在多变量分析中，SPD仅与VOmax相关。
慢性结节病患者的DL似乎主要因VOmax受损而降低。
