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- Engvall, I-LKarolinska Institutet (author)
Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor
- Article/chapterEnglish2008
Publisher, publication year, extent ...
- 2009-07-12
- Informa UK Limited,2008
- printrdacarrier
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- LIBRIS-ID:oai:DiVA.org:uu-104609
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-104609URI
- https://doi.org/10.1080/03009740802055984DOI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:117676506URI
Supplementary language notes
- Language:English
- Summary in:English
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- SwePubSwePub
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- OBJECTIVES: To examine the impact of inflammation, insulin-like growth factor (IGF-1) and its regulating binding protein (IGFBP-1) on lean body mass (LBM) in patients with rheumatoid arthritis (RA). METHODS: In 60 inpatients (50 women), inflammatory activity was measured by Disease Activity Score 28 (DAS28), C-reactive protein (CRP), and interleukin (IL)-6, and physical disability by the Health Assessment Questionnaire (HAQ). LBM was assessed by dual-energy X-ray absorptiometry (DXA) and fat free mass index (FFMI; kg/m(2)) and fat mass index (FMI; kg/m(2)) were calculated. RESULTS: Median age was 65 years and disease duration 13 years. Fifty per cent of the patients had FFMI below the 10th percentile of a reference population and 45% had FMI above the 90th percentile, corresponding to the condition known as rheumatoid cachexia (loss of muscle mass in the presence of stable or increased FM). DAS28, CRP, and IL-6 correlated negatively with LBM (p = 0.001, 0.001, and 0.018, respectively), as did HAQ (p = 0.001). Mean (confidence interval) IGF-1 was in the normal range, at 130 (116-143) microg/L. IGFBP-1 levels were elevated in patients (median 58 microg/L in women and 59 microg/L in men) compared with a normal population (33 microg/L in women and 24 microg/L in men). The ratio IGF-1/IGFBP-1, which reflects bioavailable IGF-1, was low (2.0 microg/L) and was positively correlated with LBM (p = 0.015). In multiple regression analysis, 42% of the LBM variance was explained by IGF-1/IGFBP-1, HAQ score, and DAS28. CONCLUSION: A large proportion of RA inpatients, mainly women, had rheumatoid cachexia. The muscle wasting was explained by inflammatory activity and physical disability as well as low bioavailable IGF-1.
Subject headings and genre
- MEDICINE
- MEDICIN
Added entries (persons, corporate bodies, meetings, titles ...)
- Elkan, A-CKarolinska Institutet (author)
- Tengstrand, B (author)
- Cederholm, TKarolinska Institutet,Uppsala universitet,Klinisk nutrition och metabolism,Clinical Nutrition and Metabolism(Swepub:uu)tomce419 (author)
- Brismar, KKarolinska Institutet (author)
- Hafstrom, IKarolinska Institutet (author)
- Karolinska InstitutetKlinisk nutrition och metabolism (creator_code:org_t)
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- In:Scandinavian Journal of Rheumatology: Informa UK Limited37:5, s. 321-80300-97421502-7732
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- Engvall, I-L
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- Tengstrand, B
- Cederholm, T
- Brismar, K
- Hafstrom, I
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