News Article | November 12, 2016
WASHINGTON -- Rheumatoid arthritis is associated with serious risk of cardiovascular (CV) disease events such as heart attack or stroke. Over a 15-year period, people with RA may have double the risk of CV events as those in the general population, rates that are similar to people with type-2 diabetes, according to new research findings presented this week at the 2016 ACR/ARHP Annual Meeting in Washington. Rheumatoid arthritis (RA) is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men. Researchers at Amsterdam Rheumatology Immunology Center, VU University Medical Center and Reade in the Netherlands set out to learn more about the causes of increased mortality among people with RA, and the severity of their risk. "In daily clinical practice, it seemed that RA patients more frequently suffered from myocardial infarctions than people in the general population. We started this study more than 15 years ago, as at that time, there were only sparse data with respect to cardiovascular morbidity in RA," said Prof. Michael T. Nurmohamed, MD, PhD, Head of the Rheumatology Research Department and one of the study's lead authors along with Rabia Acga, MD. Data from the CARRÉ Study, a prospective cohort study whose aim is to investigate CVD risk factors in a random sample of 353 patients with long-term RA, researchers at VU University Medical Center Amsterdam in the Netherlands assessed heart disease-related events at 3, 10, and 15 years of follow-up. They compared their findings from these RA patients to glucose metabolism and CVD risk factors data from the Hoom Study of 2,540 patients in the general population. The researchers found that risk of cardiovascular events for people with established RA was more than double that of people in the general population. Their findings showed that 96 people in the RA group had a CVD event during 2,703 person-years of follow-up, or an incidence rate of 3.6 per 100 person-years. In the general population group, 298 individuals had a CV event during a follow-up of 25,335 person-years, or an incidence rate of 1.4 per 100 person-years. Out of those 298 patients, 41 had diabetes mellitus. Age- and sex-adjusted hazard rates for CV events were higher for both RA and diabetes compared to those in the general population. Increased risk for heart attacks or strokes among people with established RA is comparable to individuals with type-2 diabetes. The increased risk for RA patients even after adjustments were made for traditional heart-disease risk factors remained elevated as much as 70 percent compared to the general population, the study showed. Their findings indicate that chronic, systemic inflammation in RA contributes independently to cardiovascular risks for these patients. "In RA, there is also a need for cardiovascular risk management, just as in diabetes," said Dr. Nurmohamed. "There is a need for attention to this by patients as well as their treating rheumatologists. Cardiovascular risk management in RA should target disease activity as well as traditional cardiovascular risk factors. Unfortunately, despite all the knowledge, the latter is only poorly implemented." Treating systemic inflammation effectively may address the increased risk of cardiovascular events and the higher mortality risk associated with them, said Dr. Nurmohamed. "There's accumulating evidence that biologics reduce the cardiovascular risk in RA. However, the current strategy of tapering biologics might impose our patients to an increased cardiovascular disease risk," he said. "We aim to conduct some mechanistic studies in this respect." Improvement of current cardiovascular risk prediction models by adding relevant biomarkers may also help rheumatologists better understand who in the RA population is most at risk for CV events and why, so effective interventions may be identified, he said. About the American College of Rheumatology Headquartered in Atlanta, Ga., the American College of Rheumatology is an international medical society representing over 9,400 rheumatologists and rheumatology health professionals with a mission to Advance Rheumatology! In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit http://www. . The ACR/ARHP Annual Meeting is the premier meeting in rheumatology. With more than 450 sessions and thousands of abstracts, it offers a superior combination of basic science, clinical science, tech-med courses, career enhancement education and interactive discussions on improving patient care. For more information about the meeting, visit http://www. , or join the conversation on Twitter by following the official #ACR16 hashtag.
Landi F.,Catholic University of the Sacred Heart |
Abbatecola A.M.,Italian National Research Center on Aging |
Provinciali M.,Immunology Center |
Corsonello A.,Research Hospital of Cosenza |
And 5 more authors.
Biogerontology | Year: 2010
Frailty is a common condition in older persons and has been described as a geriatric syndrome resulting from age-related cumulative declines across multiple physiologic systems, with impaired homeostatic reserve and a reduced capacity of the organism to resist stress. Therefore, frailty is considered as a state of high vulnerability for adverse health outcomes, such as disability, falls, hospitalization, institutionalization, and mortality. Regular physical activity has been shown to protect against diverse components of the frailty syndrome in men and women of all ages and frailty is not a contra-indication to physical activity, rather it may be one of the most important reasons to prescribe physical exercise. It has been recognized that physical activity can have an impact on different components of the frailty syndrome. This review will address the role of physical activity on the most relevant components of frailty syndrome, with specific reference to: (i) sarcopenia, as a condition which frequently overlaps with frailty; (ii) functional impairment, considering the role of physical inactivity as one of the strongest predictors of physical disability in elders; (iii) cognitive performance, including evidence on how exercise and physical activity decrease the risk of early cognitive decline and poor cognition in late life; and (iv) depression by reviewing the effect of exercise on improving mood and increasing positive well-being. © 2010 Springer Science+Business Media B.V.
Kanoni S.,Harokopio University |
Dedoussis G.V.,Harokopio University |
Herbein G.,University of Franche Comte |
Fulop T.,Université de Sherbrooke |
And 9 more authors.
Journal of Nutritional Biochemistry | Year: 2010
Although zinc plays an important role in health status of the elderly, their dietary habits in relation to zinc intake are not well documented. The main objective of the current study was the assessment of dietary zinc intake in European old populations and the investigation of its impact on plasma zinc and inflammatory cytokines concentrations, in relation to genetic markers. Within the ZINCAGE study, 819 healthy old Europeans (≥60 years old) were recruited. Plasma zinc, interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured. Genotype data were obtained for the -174G/C polymorphism in the IL-6 gene. Dietary data were collected with a food frequency questionnaire and were used to calculate a zinc diet score. Zinc score was validated using additional dietary data (24-h recalls), in a subsample of 105 subjects. Zinc score was different among most of the European centres (P<.001), while an age-dependent decline was documented (P=4.4×10-12). Plasma zinc concentrations were significantly correlated with the zinc score (standardized β=0.144, P=8.8×10-5). The minor allele frequency for the -174G/C polymorphism was f(C) 0.31. There was a significant interaction of zinc diet score and GG (-174G/C) genotype on higher plasma IL-6 levels (β±S.E.=0.014±0.0, P=.008). The main finding of our study was the detection of gene-nutrient and biochemical-nutrient interactions in a multiethnic cohort based on a common dietary assessment tool. © 2010 Elsevier Inc.
Uciechowski P.,RWTH Aachen |
Oellig E.M.,RWTH Aachen |
Mariani E.,University of Bologna |
Malavolta M.,Immunology Center |
And 2 more authors.
Immunity and Ageing | Year: 2013
Background: Advanced age results in crucial alterations of the innate and adaptive immune system leading to functional defects resulting in infection and chronic diseases. Toll-like receptors (TLR) recognize pathogenic structures and are important in the immune response to infections and vaccination. However, the role of TLR single nucleotide polymorphisms (SNP) is poorly understood in the setting of human ageing. This study investigated the impact of the TLR1 SNPs A743G and T1805G on ageing in different age groups from two European populations.Results: The TLR1 genotypes 743AA/1805GG (TLR1neg) are associated with a TLR1 negative phenotype, impaired function and susceptibility to tuberculosis. Carriers of heterozygous 743AG/1805TG and homozygous 743GG/1805TT genotypes (TLR1pos) have a TLR1 positive phenotype. By comparing healthy young and old German donors, the old group showed a tendency to carry more TLR1neg and less homozygous TLR1pos genotypes. Anti-inflammatory Interleukin (IL)-1 receptor antagonist (Ra) was significantly elevated in supernatants of mononuclear cells from old German subjects with a TLR1pos genotype in contrast to those with the 743AA genotype. Healthy old individuals and nonagenarians from Italy displayed significantly higher frequencies of TLR1pos genotypes than the old group from Germany. The data show that tumor-necrosis-factor (TNF)α, CXCL8 and CCL2 levels were higher in old donors from Germany than in plasma levels from old Italian donors. TNFα and CCL2 levels were significantly raised in old German individuals compared to Italian nonagenarians. German and Italian donors with the TLR1neg genotype basically produced more CCL2 than older European donors with TLR1pos genotypes.Conclusion: The higher frequency of the TLR1pos genotype in elderly Italian subjects may result from different ethnic populations. Lower inflammatory mediator release of aged Italian individuals is probably due to different background in nutrition, diet, genetics and to psychological aspects. Elderly donors carrying TLR1pos genotypes basically release more anti-inflammatory IL-1Ra and less inflammatory CCL2 suggesting a decline of the pro-inflammatory status found in ageing and, therefore, this may define an anti-inflammatory phenotype. Future studies are needed to elucidate the association of a TLRpos genotype with decreased susceptibility to infections and reduced risk to develop artherosclerosis. © 2013 Uciechowski et al.; licensee BioMed Central Ltd.