Comparison of self-report and objective measures of physical activity in US adults with osteoarthritis

To describe levels of daily physical activity and examine the extent of agreement between self-reported and objectively measured indices of physical activity, and characteristics associated with under or overestimated physical activity among persons with osteoarthritis (OA). Using cross-sectional data from the 2003–2006 National Health and Nutrition Examination Survey, we identified 533 adults ≥45 years of age with self-reported OA who completed physical activity questionnaires and had accelerometry data collected using Actigraph AM-7164. Average daily minutes of moderate to vigorous activity and 95 % confidence intervals (95 % CIs) using self-reported and objective measures were compared across sociodemographic and clinical subgroups and Spearman’s rank correlations were calculated. Differences between self-reported and objectively measured moderate to vigorous activity across various personal characteristics were also estimated. Most persons with OA were non-Hispanic white (87.9 %) and women (68.9 %) with an average age of 65 years old. Self-reported measure of daily moderate to vigorous activity was on average 7 min higher compared to objective measure (17.9 vs. 10.8 min/day). Correlations between self-reported and objective measures across sociodemographic groups were mostly weak to moderate ranging from 0.01 to 0.48. Participants with higher education and better self-reported health status were more likely to over-estimate their moderate to vigorous activity using self-reported measures. Measurement methods and sociodemographic and health factors are associated with differences in reporting physical activity among persons with OA. Future research examining relationships between physical activity and health outcomes in OA should be aware of measurement issues and differences of reporting in subgroups.     

Relating wrist accelerometry measures to disability in older adults

ObjectiveThis analysis assessed the extent to which: (1) wrist accelerometer measures were associated with difficulty performing specific activities of daily living and instrumental activities of daily living and (2) these measures contributed important information about disability beyond a typical self-reported vigorous activity frequency question.MethodsWe used data from the National Social Life, Health and Aging Project (NSHAP) accelerometry sub-study (n = 738). Activity was assessed using two wrist-accelerometer measures assessed over 3 days (routine activity expressed as mean count/15 s epoch during wake time, and immobile time expressed as the proportion of wake time spent immobile), and self-reported average vigorous activity frequency. The association between routine activity, immobile time and difficulty performing fourteen activities of daily living (ADLs) and instrumental activities of daily living (IADLs) plus two summary measures (any ADL or IADL difficulty), was assessed using logistic regression models, with and without controlling for self-reported vigorous activity.ResultsSelf-reported activity was mildly correlated with routine activity (r = 0.27) and immobile time (r = −0.21). Routine activity, immobile time, and self-reported vigorous activity were significantly associated with twelve, ten, and fourteen disability measures, respectively. After controlling for self-reported activity, significant associations remained between routine activity and eight disabilities, and immobile time and six disabilities.ConclusionWrist accelerometry measures were associated with many ADL and IADL disabilities among older adults. Wrist acclerometry in older adults may be useful to help assess disability risks and set individualized physical activity targets.     

Physical activity levels in adults with congenital heart disease.

BACKGROUND: Regular physical activity is associated with many health benefits in patients with cardiac disease. Advances in treatment have resulted in an increasing population of adults with congenital heart disease. Few data are available on physical activity levels and attitude to exercise in this group. DESIGN: Prospective, cross-sectional study of patients attending the adult congenital heart disease clinic in a supra-regional centre. METHODS: Physical activity assessed over 1 week using two accelerometers. The Actigraph was used to measure total activity volume and intensity and the Caltrac used to measure energy expenditure in physical activity. Patients completed a questionnaire to assess exercise self-efficacy. RESULTS: In all, 61 adults recruited (36 male; mean-age 31.7+/-10.9 years); divided into three groups according to New York Heart Association class [Group I (n=26; 14 male), Group II (n=18; 10 male), Group III (n=17; 11 male)]. Fourteen patients were overweight (body mass index 25-29.9) and seven obese (body mass index>30). Group 1 achieved similar activity levels to a sedentary reference population. Group II and III had significantly lower activity (55 and 40% of Group I). Most study patients failed to achieve UK national guidelines for physical activity (Groups I: 77%, II: 84%, III: 100%). Despite this, questionnaire responses suggested a willingness to participate in exercise in the majority of each group. CONCLUSIONS: Adults with congenital heart disease have a range of physical activity levels between normal and severely limited. Most patients showed a willingness to participate in exercise but were uncertain of the safety or benefit. Intervention to increase physical activity levels may be a low risk, low cost treatment strategy.     

The Impact of Job Conditions on Health-Related Quality of Life among Working Japanese Older Adults: A Five-Year Longitudinal Study Using J-MICC Okazaki Study Data

ObjectivesThe number of older adults who continue working after retirement is increasing in Japan. Little is known about how job conditions affect older adults’ health. We examined the association between job conditions and health-related quality of life (HRQOL) during a five-year follow-up study.MethodsThis study included participants aged 65 years or older from the Japan Multi-Institutional Collaborative Cohort Study in the Okazaki area recruited at baseline between 2007 and 2011 and followed up five years later. Participants completed a self-reported questionnaire on the physical and mental health aspects of HRQOL (SF-8™), employment status, and job conditions (job satisfaction, skill use, and job suitability).ResultsData of 1,146 men and 522 women were analyzed (mean age: 69.1 and 68.6 years, respectively). Generalized mixed linear regression analysis revealed that, compared to the not-working group, skill use was positively associated with mental health aspects among men (skill use × time: β = 0.16, SE = 0.08, p < 0.05), while poor job satisfaction and job suitability were negatively associated with mental health aspects among women (job satisfaction, not satisfied × time: β = -0.93, SE = 0.47, p < 0.05; job suitability, not suitable × time: β = -1.06, SE = 0.50, p < 0.05).ConclusionsRegarding job conditions among older adults, skill use in men was marginally associated with mental health, and poor job satisfaction and suitability in women were negatively associated with mental health. Considering the job conditions of older workers is necessary to protect their mental health.     

Factors associated with falls in active older adults in Japan and Brazil

Background/PurposeAging populations are a global public health concern. The risk of falls increases with age, so fall prevention is becoming an important health issue. However, few studies have focused on cross-cultural analyses of falls. Therefore, we aimed to compare the incidence of falls and compare anthropometric measures and physical function between active Japanese and Brazilian older adults.Materials and methodsWe measured the incidence of falls (investigated by self-reported questionnaire), body mass index (BMI), waist circumference (WC), grip strength (GS), one-legged stance (BALANCE), frequency of physical activity (PA), medication use (MU), and hospitalization history in 114 physically active community-dwelling adults 65 years of age and older in Japan (73.9 ± 4.0 years, n = 40) and Brazil (70.7 ± 4.5 years, n = 74).ResultsThe Japanese elderly were older (p < 0.01), but had a better BALANCE score (p < 0.05) than the Brazilian elderly. Nevertheless, Brazilian elderly showed higher engagement in PA and had higher BMI and WC (p < 0.01). Despite the lack of a difference in the incidence of falls between the two cohorts, Japanese elderly who fell had decreased GS compared to Japanese elderly who did not fall [odds ratio (OR): 0.83, 95% confidence interval (CI) 0.72–0.97, p < 0.05]. In Brazil, those who fell had larger WC than those who did not fall (OR: 1.07, 95% CI 1.01 – 1.13, p < 0.01).ConclusionOur results indicate that physical function (i.e., grip strength) is a more important predictor of falls in Japanese elderly. However, increasing waist size is a predictor of falls in Brazilian elderly. These findings suggest that risk factors for falls are multifactorial and vary according to setting.     

Association between the visceral adiposity index and risks of all-cause and cause-specific mortalities in a large cohort: Findings from the UK biobank

Background and aimsThe visceral adiposity index (VAI) has been recently established as a measure of visceral fat distribution and is shown to be associated with a wide range of adverse health events. However, the precise associations between the VAI score and all-cause and cause-specific mortalities in the general population remain undetermined.Methods and resultsIn this large-scale prospective epidemiological study, 357,457 participants (aged 38–73 years) were selected from the UK Biobank. We used Cox competing risk regression models to estimate the association between the VAI score and all-cause, cardiovascular disease (CVD), cancer, and other mortalities. The VAI score was significantly correlated with an increased risk of all-cause mortality (hazard ratio [HR], 1.200; 95% confidence interval [CI], 1.148–1.255; P < 0.0001), cancer mortality (HR, 1.224; 95% CI, 1.150–1.303; P < 0.0001), CVD mortality (HR, 1.459; 95% CI, 1.148–1.255; P < 0.0001), and other mortalities (HR, 1.200; 95% CI, 1.148–1.255; P < 0.0001) after adjusting for a series of confounders. In addition, the subgroup analyses showed that HRs were significantly higher in participants who were male, aged below 65 years, and body mass index less than 25.ConclusionIn summary, VAI was positively associated with an increased risk of all-cause and cause-specific mortalities in a nationwide, well-characterised population identified in a UK Biobank. The VAI score might be a complementary traditional predictive indicator for evaluating the risk of adverse health events in the population of Western adults aged 38 years and older.     

Physical activity in middle-aged adults reduces risks of functional impairment independent of its effect on weight

OBJECTIVES: To assess the association between physical activity and subsequent physical functioning in middle-aged adults across a range of body mass index (BMI) categories.
DESIGN: Prospective nationally representative cohort studies.
SETTING: The United States and England.
PARTICIPANTS: Eight thousand seven hundred two individuals in the United States and 1,507 in England aged 50 to 69 and free of impairment at baseline, followed up for 6 years.
MEASUREMENTS: Self-reported and measured BMI and self-reported level of physical activity. Outcome measures were score on a physical performance battery and self-reported mobility impairment.
RESULTS: In both studies, being overweight and being obese were associated with greater risk of impairment (than being of recommended weight). In all weight categories and both countries, higher levels of physical activity were associated with lower risks of mobility impairment. For example, U.S. respondents of recommended weight (BMI 20–25) who were active on 3 or more days per week had a relative risk (RR) of incident mobility difficulties, compared with those who were less active, of 0.56 (95% confidence interval (CI)=0.40–0.78); for those who were obese (BMI ≥30) the corresponding RR was 0.59 (95% CI=0.45–0.76).
CONCLUSION: Excess bodyweight is a risk factor for impaired physical function in middle-aged and older people. Physical activity is protective of impaired physical functioning in this age group in subjects with recommended weight, overweight, and obesity. Older adults should be encouraged to engage in appropriate levels of physical activity irrespective of their weight.     

All-cause and cardiovascular mortality risk in U.S. adults with and without type 2 diabetes: Influence of physical activity,pharmacological treatment and glycemic control

AimsThis study determined the joint association between physical activity, pharmacotherapy, and HbA1c control on all-cause and cardiovascular disease (CVD) mortality risk in adults with and without type 2 diabetes (T2D).Methods12,060 adults from NHANES III and NHANES continuous (1999–2002) surveys were used. Cox proportional hazards analyses were included to estimate mortality risk according to physical activity, pharmacotherapy, and glycemic control (HbA1c < 7.0%) status, with physically active, treated and controlled (goal situation) as the referent.ResultsCompared to the referent, adults with T2D who were uncontrolled, or controlled but physically inactive had a higher all-cause mortality risk (p < 0.05). Compared to the referent, only adults with T2D who were physically inactive had a higher CVD mortality risk, regardless of treatment or control status (p < 0.05). Normoglycemic adults had a similar all-cause and CVD mortality risk as the referent (p > 0.05).ConclusionsPhysical activity and glycemic control are both associated with lower all-cause and CVD mortality risk in adults with T2D. Adults with T2D who are physically active, pharmacologically treated, and obtain glycemic control may attain similar mortality risk as normoglycemic adults.     

Anti-cyclic citrullinated peptide antibodies do not reflect self-reported disability and physical health in patients with rheumatoid arthritis of less than 5 years of duration

It is well accepted that patients with antibodies against cyclic citrullinated peptides (anti-CCP) and rheumatoid arthritis (RA) suffer from more severe forms of RA in terms of clinical presentation and radiographic destruction at long term compared to anti-CCP-negative patients. The purpose of this cross-sectional study was to investigate whether the measures of self-reported health among patients with RA of <5 years of duration are influenced by anti-CCP status. Additionally, we aimed to determine whether the measures of self-reported health among the two patient groups differ from those of a control group. Telephone interviews were conducted with 464 patients with RA and 637 population controls, who reported educational level, income, smoking habits and lifestyle 10 years before the interview and completed the Health Assessment Questionnaire and the Short-Form Health Survey Questionnaire, version 2 (SF-36v2); 424 (91 %) patients submitted a blood sample for analysis. Patients with anti-CCP-positive and anti-CCP-negative RA showed no significant differences in self-reported disability and physical health after adjustment for age, gender, socioeconomic factors, lifestyle and disease-related variables (p > 0.05). Both groups of RA patients reported significantly more physical disabilities in everyday life and significantly poorer physical health than the controls (both p < 0.001). A similar pattern was seen for self-reported mental health (both p < 0.05). Patients with RA of <5 years of duration report significantly more disability and poorer physical health than the general population of Denmark, but these reports were independent of anti-CCP status.     

Association between self-reported physical activity and indicators of cardiovascular risk in community-dwelling older adults with hypertension in Korea: A cohort study

The prevalence of hypertension has increased with the rise in the elderly population, and high blood pressure is a major cause of cardiovascular disease. Physical activity is an important strategy for preventing cardiovascular disease. The study aimed to explore the association between physical activity and cardiovascular risk indicators in community-dwelling older adults with hypertension.This study is a secondary data analysis of a prospective longitudinal study using data from the Elderly Cohort Database of the National Health Insurance Service in South Korea between 2002 and 2013. Participants included 10,588 older adults (≥60 years) with hypertension. Data assessing self-reported physical activity and directly measured blood pressure, fasting blood glucose, body mass index, and total cholesterol levels throughout the 12-year study were extracted from the original database and analyzed. Participants were categorized into 4 groups based on the reported changes in physical activity over time: Group I (Maintaining No Physical Activity Group), II (Changing from No Physical Activity to Physical Activity Group), III (Changing from Physical Activity to No Physical Activity Group), and IV (Maintaining Physical Activity Group). Cox proportional hazard model was used to confirm the risk of cardiovascular indicators over time in each group.Participants’ mean age was 64.2 years in the initial year of 2002. The number of participants in Groups I, II, III, and IV was 4032, 2697, 1919, and 1940, respectively. Group IV showed a significant decline in risk for uncontrolled hypertension compared to Group I (hazard ratio = 0.87, 95% confidence interval [0.800–0.948]). Group II showed a significant decrease in risk for uncontrolled diabetes compared to Group I (hazard ratio = 0.94, 95% confidence interval [0.888–0.999]).The findings indicated that physical activity is a significant factor associated with indicators of cardiovascular risk in older people with high blood pressure. Healthcare providers should be aware of the importance of older adults’ physical activity and encourage them to perform and maintain it steadily for better long-term cardio-metabolic outcomes.     

Associations of resting and peak fat oxidation with sex hormone profile and blood glucose control in middle-aged women

Background and aimsMenopause may reduce fat oxidation. We investigated whether sex hormone profile explains resting fat oxidation (RFO) or peak fat oxidation (PFO) during incremental cycling in middle-aged women. Secondarily, we studied associations of RFO and PFO with glucose regulation.Method and resultsWe measured RFO and PFO of 42 women (age 52–58 years) with indirect calorimetry. Seven participants were pre- or perimenopausal, 26 were postmenopausal, and nine were postmenopausal hormone therapy users. Serum estradiol (E2), follicle-stimulating hormone, progesterone, and testosterone levels were quantified with immunoassays. Insulin sensitivity (Matsuda index) and glucose tolerance (area under the curve) were determined by glucose tolerance testing. Body composition was assessed with dual-energy X-ray absorptiometry; physical activity with self-report and accelerometry; and diet, with food diaries. Menopausal status or sex hormone levels were not associated with the fat oxidation outcomes. RFO determinants were fat mass (β = 0.44, P = 0.006) and preceding energy intake (β = ?0.40, P = 0.019). Cardiorespiratory fitness (β = 0.59, P = 0.002), lean mass (β = 0.49, P = 0.002) and physical activity (self-reported β = 0.37, P = 0.020; accelerometer-measured β = 0.35, P = 0.024) explained PFO. RFO and PFO were not related to insulin sensitivity. Higher RFO was associated with poorer glucose tolerance (β = 0.52, P = 0.002).ConclusionAmong studied middle-aged women, sex hormone profile did not explain RFO or PFO, and higher fat oxidation capacity did not indicate better glucose control.     

Poor agreement of objectively measured and self-reported physical activity in juvenile dermatomyositis and juvenile systemic lupus erythematosus

To examine the agreement and association between objectively measured and indirectly assessed physical activity levels in patients with juvenile dermatomyositis (JDM) and juvenile systemic lupus erythematosus (JSLE) patients. The sample consisted of 19 JDM patients (age 8 to 22 years) and 20 JSLE patients (age 9 to 18 years). Physical activity level was objectively measured using Actigraph® accelerometers and indirectly assessed by the short-form International Physical Activity Questionnaire (IPAQ). Spearman’s correlation coefficients were calculated to test possible associations between physical activity levels across the two instruments. The Bland–Altman technique was used to calculate bias and limits of agreement. Correlations between objectively measured and indirectly assessed physical activity levels in JDM and JSLE were weak, varying from R?=?0.03 to R?=?0.33 (all p?>?0.05). Total physical activity was correlated between accelerometer and IPAQ in JSLE (R?=?0.51, p?=?0.021). Bland–Altman analyses suggested that IPAQ tended to highly underestimate sedentary time and light physical activity in JDM (mean bias 105.7 and 199.8 min, respectively) and JSLE (mean bias 36.4 and 127.8 min, respectively). Mean biases of moderate-to-vigorous physical activity were also highly variable, ranging from ?42.9 to 54.9 min and ?59.4 to 89.8 min for JDM and JSLE, respectively. IPAQ was shown to not be valid to assess physical activity levels in patients with JDM and JSLE when compared against accelerometry. While the validation of reliable self-reported instruments that measure physical activity in pediatric rheumatic patients remains necessary, the use of validated tools that objectively measure physical activity is recommended in both clinical and research settings.     

Age modify the associations of obesity,physical activity,vision and grip strength with functional mobility in Irish aged 50 and older

ObjectiveTo estimate whether the associations of obesity, physical activity, vision and grip strength with functional mobility were modified by age.MethodsData from The Irish Longitudinal Study on Ageing (2009–2012) were analyzed and 5001 individuals were included in this study. Mobility was assessed by the timed up and go test (TUG-test). Main exposure variables were obesity, physical activity, visual acuity and grip strength at baseline. Multiple linear regression models were fitted to assess the associations of baseline main exposure variables with 2-year follow-up functional mobility and potential confounders were adjusted. Stratified analyses by age were used to assess the interaction between main exposures and age on functional mobility.ResultsMultiple linear regression models identified significant interactions of obesity (P < 0.001), vigorous physical activity (P = 0.001), vision (P < 0.001) and grip strength (P < 0.001) with age on functional mobility. Stratified analyses suggested that the risk effect of obesity on functional mobility was greater in middle-aged group (β = 0.025, P < 0.001) than in older group (β = 0.016, P = 0.017). The protective effects of high level of physical activity and grip strength on functional mobility were stronger in older group (β = −0.023, P = 0.004 for physical activity; β = −0.002, P < 0.001 for grip strength) than in middle-aged group (β = −0.012, P = 0.008 for physical activity; β = −0.0015, P < 0.001 for grip strength). The benefit of better vision on functional mobility was observed in middle-aged group only (β = −0.032, P = 0.002).ConclusionNon-obesity, higher level of physical activity, vision and grip strength at baseline were associated with better mobility performance among middle-aged and older Irish. And these associations were modified by age.     

Use of fish oil and mortality of patients with cardiometabolic multimorbidity: A prospective study of UK biobank

Background and aimsCardiometabolic multimorbidity (CMM) has risen as a global issue of public health, with an in-creasing prevalence and more severe clinical prognosis. This study aimed to estimate the association between use of fish oil and mortality among patients with CMM.Methods and ResultsIn this prospective study based on UK Biobank, participants with ≥2 of cardiometabolic diseases (CMDs, including coronary heart disease [CHD], diabetes, hypertension, and stroke in this study) at recruitment were included. Use of fish oil was derived from touchscreen questionnaires at baseline. All-cause and cardiovascular mortality were accessed via electronic health-related records. Kaplan–Meier curves and flexible parametric Royston-Parmar proportion-hazard models were fitted to assess the as-sociations of fish-oil use with all-cause, cardiovascular mortality, and related life expectancy alterations. Among 30 068 participants from UK Biobank (67.9% men; mean age 61.75 years), 5357 deaths were reported during 12.03 years of follow-up. For patients with CMM, use of fish oil was associated with a 17% lower risk of all-cause mortality (95% confidence interval [95% CI] 0.78–0.88, P < 0.001), and 19% lower risk of cardiovascular mortality (95% CI 0.72–0.90, P < 0.001) in multivariable-adjusted models. At 45 years old, using fish oil was associated with 1.66 years of life expectancy gained.ConclusionAmong patients with CMM, use of fish oil was associated with a significantly reduced risk of all-cause, cardiovascular mortality, and prolonged life expectancy.     

A systematic review of physical activity levels in Native American populations in Canada and the United States in the last 50 years

Physical activity is beneficial for many chronic conditions. However, activity levels of Native Americans are not well known. This systematic review investigated if Native American populations achieve the recommended physical activity levels, compared current and past activity levels, and assessed the ability of exercise training programmes to improve health outcomes among this population. Electronic databases (e.g. MEDLINE, EMBASE) were searched and citations were cross‐referenced. Included articles reported physical activity levels or investigations among Native Americans. This search identified 89 articles: self‐report (n = 61), accelerometry and pedometry (n = 10), metabolic monitoring (n = 10) and physical activity interventions (n = 17). Few adults were found to meet the physical activity recommendations (27.2% [95% confidence interval = 26.9–27.5%] self‐report, 9% [4–14%] accelerometry). Among children/youth, 26.5% (24.6–28.4%) (self‐report) to 45.7% (42.3–49.1%) (pedometry/accelerometry) met the recommendations. Adults and children/youth were generally identified as physically inactive (via doubly labelled water). Overall, Native American adults reported lower activity levels since 2000, compared to 1990s, although similar to 1980s. Few physical activity interventions employed strong methodologies, large sample sizes and objective outcome measures. There is a clear need to increase Native American populations' physical activity. Additional research is required to evaluate exercise training programmes among this population.     

The effect of diabetes on disability in middle-aged and older adults

BACKGROUND: Physical disability is increasingly recognized as an adverse health consequence of type 2 diabetes in older adults. We studied the effect of diabetes on disability in middle-aged and older adults to: 1) characterize the association of diabetes with physical disability in middle-aged adults, and 2) determine the extent to which the effect of diabetes is explained by related covariates in either or both age groups. METHODS: We used data from two parallel national panel studies of middle-aged and older adults to study the effect of self-reported diabetes at baseline on disability 2 years later, adjusting for baseline covariates. RESULTS: Diabetes was strongly associated with subsequent physical disability (measured by a composite variable combining activities of daily living, mobility, and strength tasks) in middle-aged and older adults. Controlling for socioeconomic characteristics and common diabetes-related and unrelated comorbidities and conditions reduced the diabetes effect substantially, but it remained a significant predictor of disability in both groups. CONCLUSIONS: Our analyses demonstrated that disability is an important diabetes-related health outcome in middle-aged and older adults that should be prevented or mitigated through appropriate diabetes management.     

Assessing the effect of interaction between an FTO variant (rs9939609) and physical activity on obesity in 15,925 Swedish and 2,511 Finnish adults

Aims/hypothesis  Recent reports have suggested that genotypes at the FTO locus interact with physical activity to modify levels of obesity-related traits. We tested this hypothesis in two non-diabetic population-based cohorts, the first from southern Sweden and the second from the Botnia region of western Finland. Methods  In total 2,511 Finnish and 15,925 Swedish non-diabetic middle-aged adults were genotyped for the FTO rs9939609 variant. Physical activity was assessed by questionnaires and standard clinical procedures were conducted, including measures of height and weight and glucose regulation. Tests of gene × physical activity interaction were performed using linear interaction effects to determine whether the effect of this variant on BMI is modified by physical activity. Results  The minor A allele at rs9939609 was associated with higher BMI in both cohorts, with the per allele difference in BMI being about 0.13 and 0.43 kg/m² in the Swedish and Finnish cohorts, respectively (p < 0.0001). The test of interaction between physical activity and the rs9939609 variant on BMI was not statistically significant after controlling for age and sex in either cohort (Sweden: p = 0.71, Finland: p = 0.18). Conclusions/interpretation  The present report does not support the notion that physical activity modifies the effects of the FTO rs9939609 variant on obesity risk in the non-diabetic Swedish or Finnish adults studied here. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Serum and synovial fluid leptin levels and markers of inflammation in rheumatoid arthritis

This study was designed to investigate the serum and synovial fluid leptin levels, and inflammatory markers in rheumatoid arthritis (RA) patients. Serum and synovial fluid leptin levels were significantly higher (P > 0.05) in RA patients than control group; RA patients with moderate disease activity (DAS < 2.7) having significantly higher leptin levels (P > 0.05) than those with low disease activity (DAS < 2.7). Leukocytes and erythrocyte sedimentation rate (ESR) were found to be significantly higher in moderate disease activity RA group compared to low activity group (P > 0.05, P < 0.001, respectively). Serum leptin level is found to be independent of age and inflammatory markers. ESR is positively correlated with DAS activity and CRP values. Our finding of no correlation between leptin and BMI shows that regulation of leptinemia is complex, and leptin levels cannot be used to assess RA activity.