Wagenaar C A, Christiaans J, Hermans V, Walrabenstein W, Koopman F A, van Middendorp H, van Schaardenburg D
Reade Center for Rheumatology and Rehabilitation, Amsterdam, the Netherlands.
Department of Clinical Immunology and Rheumatology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands.
Compr Psychoneuroendocrinol. 2025 May 2;23:100298. doi: 10.1016/j.cpnec.2025.100298. eCollection 2025 Aug.
OBJECTIVE: In two randomized controlled trials, the Plants for Joints (PFJ) multidisciplinary lifestyle intervention reduced signs and symptoms of rheumatoid arthritis (RA), or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared with usual care. This secondary analysis aimed to evaluate the effect of the PFJ intervention on stress-related parameters. METHODS: In two PFJ observer-blind randomized controlled trials (RCT), people with (1) RA with low-moderate disease activity or (2) MSOA were randomized to receive the PFJ lifestyle intervention or usual care. The 16-week PFJ intervention consisted of a whole-food plant-based diet, physical activity, and sleep and stress management. This secondary analysis investigated stress-related outcomes including heart rate, heart rate variability (HRV: root square mean of successive differences (RMSSD) and normalised high frequency (HFnorm), salivary cortisol, perceived stress (Perceived Stress Scale 10; PSS-10), and time spent on stress-reducing activities. An intention-to-treat analysis with a linear regression model (HRV) or linear mixed model (cortisol and PSS-10), adjusted for baseline values, was used to analyse between-group differences. RESULTS: 77 people with RA and 64 with MSOA completed the RCT. RA participants following the PFJ intervention showed a significant improvement in HFnorm (between-group difference: 6.6; 95 % CI 0.5, 12.6) and an improving trend in RMSSD (4.3; 95 % CI -1.5, 10.1) alongside non-significant reductions of heart rate (3.1; 95 % CI-3.9, 10.1), salivary cortisol (1.3; 95 % CI -0.6, 3.1) and perceived stress (-2.0; 95 % CI -4.4, 0.3), compared to usual care. In participants with MSOA, there were no differences in heart rate, HRV outcomes, cortisol, or perceived stress between the intervention and control group. Both RA and MSOA participants temporarily increased time spent on stress-reducing activities, yet no change from baseline was observed after 16 weeks. In RA participants increased time spent on stress-reducing activities was associated with increased HFnorm. CONCLUSION: This secondary analysis suggests the PFJ program may have a positive influence on stress-related parameters in people with RA, but not MSOA, compared to usual care.
目的：在两项随机对照试验中，与常规护理相比，关节植物（PFJ）多学科生活方式干预减轻了类风湿性关节炎（RA）或代谢综合征相关的髋或膝骨关节炎（MSOA）的体征和症状。这项二次分析旨在评估PFJ干预对压力相关参数的影响。 方法：在两项PFJ观察者盲法随机对照试验（RCT）中，（1）患有低中度疾病活动度的RA或（2）MSOA的患者被随机分配接受PFJ生活方式干预或常规护理。为期16周的PFJ干预包括全食物植物性饮食、体育活动以及睡眠和压力管理。这项二次分析调查了与压力相关的结果，包括心率、心率变异性（HRV：连续差值的均方根（RMSSD）和标准化高频（HFnorm））、唾液皮质醇、感知压力（感知压力量表10；PSS-10）以及用于减压活动的时间。采用线性回归模型（HRV）或线性混合模型（皮质醇和PSS-10）进行意向性分析，并对基线值进行调整，以分析组间差异。 结果：77名RA患者和64名MSOA患者完成了RCT。接受PFJ干预的RA参与者在HFnorm方面有显著改善（组间差异：6.6；95%CI 0.5，12.6），RMSSD有改善趋势（4.3；95%CI -1.5，10.1），同时心率（3.1；95%CI -3.9，10.1）、唾液皮质醇（1.3；95%CI -0.6，3.1）和感知压力（-2.0；95%CI -4.4，0.3）与常规护理相比有不显著的降低。在MSOA参与者中，干预组和对照组在心率、HRV结果、皮质醇或感知压力方面没有差异。RA和MSOA参与者用于减压活动的时间都暂时增加了，但16周后未观察到与基线相比有变化。在RA参与者中，用于减压活动的时间增加与HFnorm增加有关。 结论：这项二次分析表明，与常规护理相比，PFJ计划可能对RA患者的压力相关参数有积极影响，但对MSOA患者没有。
Arthritis Care Res (Hoboken). 2025-4-20
Rheumatology (Oxford). 2023-8-1
BMC Musculoskelet Disord. 2008-9-16
Rheumatology (Oxford). 2023-8-1
J Pers Med. 2022-11-15
Semin Arthritis Rheum. 2022-8
Zotero 插件