Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor

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Engvall, I-LKarolinska Institutet (författare)

Cachexia in rheumatoid arthritis is associated with inflammatory activity, physical disability, and low bioavailable insulin-like growth factor

Artikel/kapitelEngelska2008

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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

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Språk:engelska
Sammanfattning på:engelska

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Ämneskategori:ref swepub-contenttype
Ämneskategori:art swepub-publicationtype

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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.

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MEDICINE
MEDICIN

Biuppslag (personer, institutioner, konferenser, titlar ...)

Elkan, A-CKarolinska Institutet (författare)
Tengstrand, B (författare)
Cederholm, TKarolinska Institutet,Uppsala universitet,Klinisk nutrition och metabolism,Clinical Nutrition and Metabolism(Swepub:uu)tomce419 (författare)
Brismar, KKarolinska Institutet (författare)
Hafstrom, IKarolinska Institutet (författare)
Karolinska InstitutetKlinisk nutrition och metabolism (creator_code:org_t)

Sammanhörande titlar

Ingår i:Scandinavian Journal of Rheumatology: Informa UK Limited37:5, s. 321-80300-97421502-7732

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Scandinavian Journal of Rheumatology (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Engvall, I-L; Elkan, A-C; Tengstrand, B; Cederholm, T; Brismar, K; Hafstrom, I

Artiklar i publikationen: Scandinavian Jou ...

Av lärosätet: Uppsala universitet; Karolinska Institutet

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