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减少类风湿性关节炎绝经后女性久坐行为的临床和心脏代谢影响

Clinical and Cardiometabolic Effects of Reducing Sedentary Behavior in Postmenopausal Women with Rheumatoid Arthritis.

作者信息

Pinto Ana Jessica, Meireles Kamila, Peçanha Tiago, Mazzolani Bruna Caruso, Smaira Fabiana Infante, Rezende Diego, Benatti Fabiana Braga, DE Medeiros Ribeiro Ana Cristina, DE Sá Pinto Ana Lúcia, Lima Fernanda Rodrigues, Roschel Hamilton, Gualano Bruno

机构信息

Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BRAZIL.

出版信息

Med Sci Sports Exerc. 2025 Jan 1;57(1):23-32. doi: 10.1249/MSS.0000000000003546. Epub 2024 Sep 16.

Abstract

PURPOSE

We investigated the effects of a 4-month intervention targeting sedentary behavior on sedentary time and physical activity level, clinical parameters, cardiometabolic risk factors, inflammatory markers, and health-related quality of life in postmenopausal women with rheumatoid arthritis.

METHODS

This was a 4-month, parallel-group, randomized controlled trial ( ClinicalTrials.gov identifier: NCT03186924). One hundred and three postmenopausal rheumatoid arthritis patients were randomized (1:1) to either a newly developed intervention targeting sedentary behavior (Take a STAND for Health [TS4H]) or standard of care (SOC). Sedentary behavior (primary outcome) and physical activity levels, clinical parameters, anthropometric parameters and body composition, blood samples and oral glucose tolerance test, blood pressure, muscle function, and health-related quality of life were assessed at baseline (Pre) and after 4 months (Post). Between- and within-group differences were tested using linear mixed models following the intention-to-treat principle.

RESULTS

Total sedentary time, time in prolonged sitting bouts, standing, and stepping did not change in either group (all P ≥ 0.337). No significant between- and within-group differences were detected for any of the clinical parameters, markers of cardiometabolic health and inflammation, and health-related quality of life variables (all P ≥ 0.136). Among responders in TS4H group (those who reduced sedentary time by ≥30 min·d -1 ), Pre to Post IL-10 concentrations tended to reduce (group-time: P = 0.086; estimated mean difference [EMD]: -12.0 pg·mL -1 [-23.5 to -0.6], P = 0.037) and general health (group-time: P = 0.047; EMD: 10.9 A.U. [-1.1 to 22.9], P = 0.086) and overall physical health tended to improve (group-time: P = 0.067; EMD: 7.9 A.U. [-0.9 to 16.6], P = 0.089).

CONCLUSIONS

TS4H did not change sedentary behavior, physical activity levels, clinical, cardiometabolic, inflammatory, or health-related quality of life outcomes. However, TS4H tended to reduce IL-10 levels and improve health-related quality of life in responders.

摘要

目的

我们研究了一项针对久坐行为的为期4个月的干预措施,对患有类风湿性关节炎的绝经后女性的久坐时间、身体活动水平、临床参数、心脏代谢危险因素、炎症标志物以及健康相关生活质量的影响。

方法

这是一项为期4个月的平行组随机对照试验(ClinicalTrials.gov标识符:NCT03186924)。103名绝经后类风湿性关节炎患者被随机(1:1)分为两组,一组接受新开发的针对久坐行为的干预措施(为健康起身活动[TS4H]),另一组接受标准护理(SOC)。在基线期(干预前)和4个月后(干预后)评估久坐行为(主要结局)、身体活动水平、临床参数、人体测量参数和身体成分、血液样本和口服葡萄糖耐量试验、血压、肌肉功能以及健康相关生活质量。按照意向性分析原则,使用线性混合模型检验组间和组内差异。

结果

两组的总久坐时间、长时间连续坐姿时间、站立时间和步数均未改变(所有P≥0.337)。在任何临床参数、心脏代谢健康和炎症标志物以及健康相关生活质量变量方面,均未检测到显著的组间和组内差异(所有P≥0.136)。在TS4H组的反应者(即久坐时间减少≥30分钟·天-1的患者)中,从干预前到干预后,白细胞介素-10浓度有降低趋势(组-时间:P = 0.086;估计平均差异[EMD]:-12.0 pg·mL-1[-23.5至-0.6],P = 0.037),总体健康状况(组-时间:P = 0.047;EMD:10.9 AU[-1.1至22.9],P = 0.086)和总体身体健康状况有改善趋势(组-时间:P = 0.067;EMD:7.9 AU[-0.9至16.6],P = 0.089)。

结论

TS4H并未改变久坐行为、身体活动水平、临床、心脏代谢、炎症或健康相关生活质量结局。然而,TS4H在反应者中倾向于降低白细胞介素-10水平并改善健康相关生活质量。

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