Matthew J Roberts, William Johnson, Sepehr Qooja, Arumugam Moorthy, Nicolette C Bishop
{"title":"肥胖和体力活动与脊柱关节病成人患者的疼痛、疲劳、僵硬和焦虑的综合关联：英国生物数据库研究。","authors":"Matthew J Roberts, William Johnson, Sepehr Qooja, Arumugam Moorthy, Nicolette C Bishop","doi":"10.1093/rap/rkae109","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory spondyloarthropathies are associated with pain, fatigue, stiffness and anxiety. The National Institute for Health and Care Excellence and the EULAR provide limited lifestyle guidance for managing symptoms with inflammatory spondyloarthropathies. We investigated the combined associations of obesity and physical activity with symptom severity in inflammatory spondyloarthropathies.</p><p><strong>Methods: </strong>The relationship between BMI, physical activity and symptom severity (spinal and general pain, fatigue, anxiety, mobility) was examined in people with ISpAs (<i>n</i> = 1577). BMI categories were normal weight (18.5-24.9 kg/m<sup>2</sup>), overweight (25.0-29.9 kg/m<sup>2</sup>) and obese (≥30 kg/m<sup>2</sup>). Physical activity was assessed via the International Physical Activity Questionnaire (low < 600 metabolic equivalent of task (MET)-min/week, moderate ≥ 600 METs, high ≥ 3000 METs). Statistical models adjusted for confounders, including medication, estimated the likelihood (odds ratios, OR) of higher symptom severity across BMI and physical activity categories.</p><p><strong>Results: </strong>Overweight and obesity, compared with normal weight, were linked to higher severity of all symptoms, with stronger associations for obesity (OR ≥ 2.34, <i>P</i> < 0.001) than overweight (OR ≥ 1.37, <i>P</i> ≤ 0.032). Moderate activity, compared with low, was associated with lower severity of all symptoms (OR ≤ 0.77, <i>P</i> ≤ 0.032). High activity, compared with low, was associated with lower severity of fatigue, anxiety and mobility issues (OR ≤ 0.74, <i>P</i> ≤ 0.029), but associations with spinal and general pain were not significant (OR ≤ 0.80, <i>P</i> ≥ 0.056). No BMI-by-physical activity combinations were detected, indicating physical activity benefits all BMI groups to a similar extent.</p><p><strong>Conclusion: </strong>National Institute for Health and Care Excellence and EULAR guidance for inflammatory spondyloarthropathies should emphasize maintaining a normal weight. Moderate physical activity is optimal for reducing symptom severity and should be promoted in lifestyle guidance.</p>","PeriodicalId":21350,"journal":{"name":"Rheumatology Advances in Practice","volume":"8 4","pages":"rkae109"},"PeriodicalIF":2.1000,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401743/pdf/","citationCount":"0","resultStr":"{\"title\":\"Combined associations of obesity and physical activity with pain, fatigue, stiffness and anxiety in adults with spondyloarthropathies: UK Biobank study.\",\"authors\":\"Matthew J Roberts, William Johnson, Sepehr Qooja, Arumugam Moorthy, Nicolette C Bishop\",\"doi\":\"10.1093/rap/rkae109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Inflammatory spondyloarthropathies are associated with pain, fatigue, stiffness and anxiety. The National Institute for Health and Care Excellence and the EULAR provide limited lifestyle guidance for managing symptoms with inflammatory spondyloarthropathies. We investigated the combined associations of obesity and physical activity with symptom severity in inflammatory spondyloarthropathies.</p><p><strong>Methods: </strong>The relationship between BMI, physical activity and symptom severity (spinal and general pain, fatigue, anxiety, mobility) was examined in people with ISpAs (<i>n</i> = 1577). BMI categories were normal weight (18.5-24.9 kg/m<sup>2</sup>), overweight (25.0-29.9 kg/m<sup>2</sup>) and obese (≥30 kg/m<sup>2</sup>). Physical activity was assessed via the International Physical Activity Questionnaire (low < 600 metabolic equivalent of task (MET)-min/week, moderate ≥ 600 METs, high ≥ 3000 METs). Statistical models adjusted for confounders, including medication, estimated the likelihood (odds ratios, OR) of higher symptom severity across BMI and physical activity categories.</p><p><strong>Results: </strong>Overweight and obesity, compared with normal weight, were linked to higher severity of all symptoms, with stronger associations for obesity (OR ≥ 2.34, <i>P</i> < 0.001) than overweight (OR ≥ 1.37, <i>P</i> ≤ 0.032). Moderate activity, compared with low, was associated with lower severity of all symptoms (OR ≤ 0.77, <i>P</i> ≤ 0.032). High activity, compared with low, was associated with lower severity of fatigue, anxiety and mobility issues (OR ≤ 0.74, <i>P</i> ≤ 0.029), but associations with spinal and general pain were not significant (OR ≤ 0.80, <i>P</i> ≥ 0.056). No BMI-by-physical activity combinations were detected, indicating physical activity benefits all BMI groups to a similar extent.</p><p><strong>Conclusion: </strong>National Institute for Health and Care Excellence and EULAR guidance for inflammatory spondyloarthropathies should emphasize maintaining a normal weight. Moderate physical activity is optimal for reducing symptom severity and should be promoted in lifestyle guidance.</p>\",\"PeriodicalId\":21350,\"journal\":{\"name\":\"Rheumatology Advances in Practice\",\"volume\":\"8 4\",\"pages\":\"rkae109\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401743/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Rheumatology Advances in Practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/rap/rkae109\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rheumatology Advances in Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/rap/rkae109","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：炎症性脊柱关节病与疼痛、疲劳、僵硬和焦虑有关。美国国家健康与护理卓越研究所（National Institute for Health and Care Excellence）和欧洲关节病学会（EULAR）为控制炎症性脊柱关节病的症状提供了有限的生活方式指导。我们研究了肥胖和体力活动与炎症性脊柱关节病症状严重程度的综合关系：我们研究了炎症性脊柱关节病患者（n = 1577）的体重指数、体力活动和症状严重程度（脊柱和全身疼痛、疲劳、焦虑、活动能力）之间的关系。体重指数分为正常体重（18.5-24.9 kg/m2）、超重（25.0-29.9 kg/m2）和肥胖（≥30 kg/m2）。体力活动通过国际体力活动问卷（低）进行评估：与正常体重相比，超重和肥胖与所有症状的严重程度有关，肥胖的相关性更大（OR ≥ 2.34，P P ≤ 0.032）。中等活动量与低活动量相比，与所有症状的严重程度较低有关（OR ≤ 0.77，P ≤ 0.032）。高活动量与低活动量相比，与疲劳、焦虑和行动不便的严重程度较低有关（OR ≤ 0.74，P ≤ 0.029），但与脊柱和全身疼痛的相关性不显著（OR ≤ 0.80，P ≥ 0.056）。没有发现体重指数与体育锻炼的组合，这表明体育锻炼对所有体重指数组的益处相似：结论：美国国家健康与护理卓越研究所和EULAR对炎症性脊柱关节病的指导应强调保持正常体重。适度的体育锻炼是降低症状严重程度的最佳方式，应在生活方式指导中加以推广。
Combined associations of obesity and physical activity with pain, fatigue, stiffness and anxiety in adults with spondyloarthropathies: UK Biobank study.
Objective: Inflammatory spondyloarthropathies are associated with pain, fatigue, stiffness and anxiety. The National Institute for Health and Care Excellence and the EULAR provide limited lifestyle guidance for managing symptoms with inflammatory spondyloarthropathies. We investigated the combined associations of obesity and physical activity with symptom severity in inflammatory spondyloarthropathies.
Methods: The relationship between BMI, physical activity and symptom severity (spinal and general pain, fatigue, anxiety, mobility) was examined in people with ISpAs (n = 1577). BMI categories were normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) and obese (≥30 kg/m2). Physical activity was assessed via the International Physical Activity Questionnaire (low < 600 metabolic equivalent of task (MET)-min/week, moderate ≥ 600 METs, high ≥ 3000 METs). Statistical models adjusted for confounders, including medication, estimated the likelihood (odds ratios, OR) of higher symptom severity across BMI and physical activity categories.
Results: Overweight and obesity, compared with normal weight, were linked to higher severity of all symptoms, with stronger associations for obesity (OR ≥ 2.34, P < 0.001) than overweight (OR ≥ 1.37, P ≤ 0.032). Moderate activity, compared with low, was associated with lower severity of all symptoms (OR ≤ 0.77, P ≤ 0.032). High activity, compared with low, was associated with lower severity of fatigue, anxiety and mobility issues (OR ≤ 0.74, P ≤ 0.029), but associations with spinal and general pain were not significant (OR ≤ 0.80, P ≥ 0.056). No BMI-by-physical activity combinations were detected, indicating physical activity benefits all BMI groups to a similar extent.
Conclusion: National Institute for Health and Care Excellence and EULAR guidance for inflammatory spondyloarthropathies should emphasize maintaining a normal weight. Moderate physical activity is optimal for reducing symptom severity and should be promoted in lifestyle guidance.
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