Clinical and Cardiometabolic Effects of Reducing Sedentary Behavior in Postmenopausal Women with Rheumatoid Arthritis

Abstract

Purpose: We investigated the effects of a 4-month intervention targeting sedentary behavior on sedentary time and physical activity level, clinical parameters, cardiometabolic risk factors, inflammatory markers, and health-related quality of life in postmenopausal women with rheumatoid arthritis.

Methods: This was a 4-month, parallel-group, randomized controlled trial ( ClinicalTrials.gov identifier: NCT03186924). One hundred and three postmenopausal rheumatoid arthritis patients were randomized (1:1) to either a newly developed intervention targeting sedentary behavior (Take a STAND for Health [TS4H]) or standard of care (SOC). Sedentary behavior (primary outcome) and physical activity levels, clinical parameters, anthropometric parameters and body composition, blood samples and oral glucose tolerance test, blood pressure, muscle function, and health-related quality of life were assessed at baseline (Pre) and after 4 months (Post). Between- and within-group differences were tested using linear mixed models following the intention-to-treat principle.

Results: Total sedentary time, time in prolonged sitting bouts, standing, and stepping did not change in either group (all P ≥ 0.337). No significant between- and within-group differences were detected for any of the clinical parameters, markers of cardiometabolic health and inflammation, and health-related quality of life variables (all P ≥ 0.136). Among responders in TS4H group (those who reduced sedentary time by ≥30 min·d -1 ), Pre to Post IL-10 concentrations tended to reduce (group-time: P = 0.086; estimated mean difference [EMD]: -12.0 pg·mL -1 [-23.5 to -0.6], P = 0.037) and general health (group-time: P = 0.047; EMD: 10.9 A.U. [-1.1 to 22.9], P = 0.086) and overall physical health tended to improve (group-time: P = 0.067; EMD: 7.9 A.U. [-0.9 to 16.6], P = 0.089).

Conclusions: TS4H did not change sedentary behavior, physical activity levels, clinical, cardiometabolic, inflammatory, or health-related quality of life outcomes. However, TS4H tended to reduce IL-10 levels and improve health-related quality of life in responders.