Liff Marthe Halsan, Hoff Mari, Wisløff Ulrik, Videm Vibeke
Clinic of Orthopaedics, Rheumatology and Dermatology, St. Olavs University Hospital, Trondheim, Norway.
Department of Rheumatology, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
Rheumatol Int. 2021 Feb;41(2):369-379. doi: 10.1007/s00296-020-04713-2. Epub 2020 Oct 9.
Primary aim: Compare change in estimated cardiorespiratory fitness (eCRF change) in rheumatoid arthritis (RA) patients with population-based age- and sex-matched controls during ~ 11-year follow-up and identify variables associated with eCRF change. Secondary aim: Compare eCRF level in RA patients and controls. eCRF change from the second (HUNT2 1995-1997) to the third (HUNT3 2006-2008) surveys of the Norwegian Trøndelag Health Study was compared between RA patients (n = 188) and controls (n = 26,202) attending both surveys. Predictors of eCRF change were identified by Lasso regression followed by multiple linear regression. Mean eCRF level in RA patients (n = 436) and controls (n = 67,910) was compared using age-adjusted linear regression stratified on sex, as well as two-sample t tests including RA patients (n = 432) and controls (n = 59,124) who attended either HUNT2, HUNT3 or both HUNT2 and HUNT3. The mean eCRF decline from HUNT2 to HUNT3 in RA patients was 8.3 mL min kg versus 6.7 mL min kg in controls (p < 0.001). The decline was faster in RA patients and larger with higher baseline age (standardized regression coefficient for RA patients: (- 0.482 × age + 0.044); controls: (- 0.367 × age, p < 0.001). The decline was also associated with smoking, cardiovascular disease, increasing body mass index, asthma, and hypertension. Mean differences in age-adjusted eCRF level for RA patients versus controls (p < 0.001): women HUNT2: - 3.2 mL min kg; HUNT3: - 5.0 mL min kg; men HUNT2: - 1.8 mL min kg; HUNT3: - 4.0 mL min kg. Higher age at baseline was associated with faster decline in eCRF. This change was more pronounced in RA patients than controls, indicating a larger negative effect on fitness of aging in RA. RA patients had lower eCRF compared to healthy individuals.
在约11年的随访期间，比较类风湿关节炎（RA）患者与基于人群的年龄和性别匹配对照组的估计心肺适能变化（eCRF变化），并确定与eCRF变化相关的变量。次要目的：比较RA患者和对照组的eCRF水平。对参加了挪威特隆赫姆郡健康研究第二次调查（HUNT2，1995 - 1997年）和第三次调查（HUNT3，2006 - 2008年）的RA患者（n = 188）和对照组（n = 26202）的eCRF变化进行了比较。通过套索回归和多元线性回归确定eCRF变化的预测因素。使用按性别分层的年龄调整线性回归以及包括参加了HUNT2、HUNT3或同时参加了HUNT2和HUNT3的RA患者（n = 436）和对照组（n = 67910）的两样本t检验，比较了RA患者和对照组的平均eCRF水平。RA患者从HUNT2到HUNT3的平均eCRF下降为8.3 mL·min⁻¹·kg⁻¹，而对照组为6.7 mL·min⁻¹·kg⁻¹（p < 0.001）。RA患者的下降更快，且基线年龄越高下降越大（RA患者的标准化回归系数：（-0.482×年龄 + 0.044）；对照组：（-0.367×年龄，p < 0.001）。下降还与吸烟、心血管疾病、体重指数增加、哮喘和高血压有关。RA患者与对照组年龄调整后的eCRF水平平均差异（p < 0.001）：女性，HUNT2时为 - 3.2 mL·min⁻¹·kg⁻¹；HUNT3时为 - 5.0 mL·min⁻¹·kg⁻¹；男性，HUNT2时为 - 1.8 mL·min⁻¹·kg⁻¹；HUNT3时为 - 4.0 mL·min⁻¹·kg⁻¹。基线年龄越高，eCRF下降越快。这种变化在RA患者中比对照组更明显，表明衰老对RA患者体能的负面影响更大。与健康个体相比，RA患者的eCRF较低。
