title: Low level of physical activity in women with rheumatoid arthritis is associated with cardiovascular risk factors but not with body fat mass--a cross sectional study.
abstract: BACKGROUND
  As many patients with rheumatoid arthritis (RA) have increased fat mass (FM) and increased frequency of cardiovascular diseases we evaluated if total physical activity (MET-hours) had impact on body composition and cardiovascular risk factors in women with RA.
  
  
  METHODS
  Sixty-one out-ward RA women, 60.8 (57.3-64.4) years, answered a self-administered questionnaire, to estimate total daily physical activity during the previous year. Physical activity level was given as metabolic equivalents (MET) × h/day. Diet content was assessed by a food frequency questionnaire and body composition by whole-body dual-energy X-ray absorptiometry. Blood lipids and antibodies against phosphorylcholine (anti-PC) were determined.
  
  
  RESULTS
  Forty-one percent of the women had BMI > 25, 6% were centrally obese and 80% had FM% > 30%. The median (IQR) total physical activity was 40.0 (37.4-47.7), i.e. the same activity level as healthy Swedish women in the same age. Total physical activity did not significantly correlate with disease activity, BMI or FM%. Disease activity, BMI and FM% did not differ between those in the lowest quartile of total physical activity and those in the highest quartile. However, the women in the lowest quartile of physical activity had lower HDL (p = 0.05), Apo A1 (p = 0.005) and atheroprotective natural anti-PC (p = 0.016) and higher levels of insulin (p = 0.05) and higher frequency of insulin resistance than those in the highest quartile. Women in the lowest quartile consumed larger quantities of saturated fatty acids than those in the highest quartile (p = 0.042), which was associated with high oxidized low-density lipoprotein (oxLDL).
  
  
  CONCLUSIONS
  This cross sectional study demonstrated that RA women with fairly low disease activity, good functional capacity, high FM and high frequency of central obesity had the same total physical activity level as healthy Swedish women in the same age. The amount of total physical activity was not associated with functional capacity or body composition. However, low total physical activity was associated with dyslipidemia, insulin resistance, low levels of atheroprotective anti-PC and consumption of saturated fatty acids, which is of interest in the context of increased frequency of cardiovascular disease in RA.
authors.affiliation: Department of Rheumatology, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden. ann-charlotte.elkan@karolinska.se
authors.forename: Ann-Charlotte
authors.initials: AC
authors.lastname: Elkan
authors.forename: Niclas
authors.initials: N
authors.lastname: Håkansson
authors.forename: Johan
authors.initials: J
authors.lastname: Frostegård
authors.forename: Ingiäld
authors.initials: I
authors.lastname: Hafström
mesh_terms: D000273:Adipose Tissue / Q000503:physiopathology*; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D010809:Physical Fitness / Q000502:physiology*; D057185:Sedentary Behavior