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Research ArticleAnkylosing Spondylitis

Associations Between Cardiorespiratory Fitness and Arterial Stiffness in Ankylosing Spondylitis: A Cross-sectional Study

Inger Jorid Berg, Anne Grete Semb, Silje H. Sveaas, Camilla Fongen, Désirée van der Heijde, Tore K. Kvien, Hanne Dagfinrud and Sella A. Provan
The Journal of Rheumatology November 2018, 45 (11) 1522-1525; DOI: https://doi.org/10.3899/jrheum.170726
Inger Jorid Berg
From the Department of Rheumatology, and the Preventive Cardio-Rheuma Clinic, Diakonhjemmet Hospital, Oslo, Norway; the Department of Rheumatology, Leiden University Medical Center, Leiden, the Netherlands.
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  • For correspondence: ingerjoridberg@gmail.com
Anne Grete Semb
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Silje H. Sveaas
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Camilla Fongen
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Désirée van der Heijde
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Tore K. Kvien
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Hanne Dagfinrud
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Sella A. Provan
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    Figure 1.

    Scatterplots for cardiorespiratory fitness and arterial stiffness. Associations between VO2peak and arterial stiffness measured as augmentation index and pulse wave velocity with a regression line. VO2peak: peak oxygen uptake.

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    Table 1.

    Characteristics of the patients.

    DemographicsN = 118
      Age, yrs, mean (SD)48.9 (11.2)
      Sex (male), n (%)75 (64)
      Current smoking, n (%)18 (15)
      BMI, kg/m2, mean (SD)25.6 (3.4)
      Height, cm, mean (SD)174 (10)
      Loss of height, cm, median (IQR)1 (0–3)
    Disease characteristics
      BASDAI, mean (SD)3.7 (1.8)
      ASDAS, mean (SD)2.3 (0.9)
      CRP, mg/l, median (IQR)3 (1–9)
    Medication, current use
      NSAID, n (%)77 (65)
      TNF-α inhibitors, n (%)24 (20)
      Statins, n (%)15 (13)
      Antihypertensives, n (%)28 (24)
    Lipids
      TC, mmol/l, mean (SD)5.4 (1.1)
      HDL-C, mmol/l, mean (SD)1.6 (0.5)
    Cardiorespiratory fitness
      VO2peak, ml/kg/min, mean (SD)39.3 (8.0)
      Maximum heart rate (bpm), mean (SD)172 (19)
      Borgs scale ≥ 17 at end of exercise test, n (%)115 (98)
    Hemodynamic
      Brachial SBP, mmHg, mean (SD)127 (17)
      Brachial DBP, mmHg, mean (SD)78 (10)
      CMAP, mmHg, mean (SD)95 (12)
      AIx (%), mean (SD)14.8 (13.1)
      PWV, m/s, median (IQR)7.3 (6.2–8.4)
      Ln(PWV + 0.5), mean (SD)1.986 (0.199)
    • AIx: augmentation index; ASDAS: Ankylosing Spondylitis Disease Activity Score; BMI: body mass index; CMAP: central mean arterial pressure; CRP: C-reactive protein; DBP: diastolic blood pressure; HDL-C: high-density lipoprotein cholesterol; IQR: interquartile range; NSAID: nonsteroidal antiinflammatory drugs; PWV: pulse wave velocity; Ln: log-transformed; SBP: systolic blood pressure; TC: total cholesterol; TNF-α: tumor necrosis factor–α; VO2peak: peak oxygen uptake; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index.

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    Table 2.

    Associations between cardiorespiratory fitness and arterial stiffness, in multivariable linear regression.

    Outcome AIxOutcome lnPWV
    UnivariateMultivariableUnivariateMultivariable
    B (95% CI)pB (95% CI)pB (95% CI)pB (95% CI)p
    Age, yrs0.8 (0.6–0.9)< 0.0010.5 (0.3–0.6)< 0.0010.012 (0.009–0.014)< 0.0010.009 (0.006–0.012)< 0.001
    Sex, male−12.5 (−16.9 to −8.0)< 0.001−9.4 (−12.6 to −6.2)< 0.0010.035 (−0.042 to 0.113)0.370.111 (0.046–0.176)0.001
    VO2peak, ml/kg/min−0.4 (−0.6 to −0.2)a0.002−0.3 (−0.6 to −0.1)0.01−0.003 (−0.007 to 0.002)a0.24−0.005 (−0.010 to −0.001)0.03
    Current smoking0.7 (−3.6 to 5.0)a0.74−0.072 (−0.147 to 0.003)a0.06
    BMI, kg/m20.2 (−0.3 to 0.6)a0.440.007 (−0.001 to 0.015)a0.09
    CRP, mg/l0.1 (−0.1 to 0.3)a0.160.002 (−0.001 to 0.005)a0.28
    ASDAS1.0 (−0.7 to 2.7)a0.250.010 (−0.022 to 0.041)a0.54
    NSAID0.2 (−3.6 to 3.1)a0.89−0.034 (−0.093 to 0.026)a0.26
    TC, mmol/l0.3 (−1.2 to 1.8)a0.670.032 (0.005−0.059)a0.020.028 (0.003–0.053)0.03
    HDL-C, mmol/l−2.9 (−6.6 to 0.8)a0.12−0.006 (−0.075 to 0.063)a0.86
    CMAP, mmHg0.3 (0.2–0.4)a< 0.0010.3 (0.1–0.4)< 0.0010.006 (0.003–0.008)a< 0.0010.004 (0.002–0.007)0.001
    Height, cm−0.1 (−0.3 to 0.1)a0.18NANA
    Loss of height, cmNANA−0.011 (−0.020 to −0.002)a0.02−0.011 (−0.020 to −0.002)0.02
    R20.690.63
    • Linear regression models with arterial stiffness as dependent variable.

    • ↵a Adjusted age and sex. AIx: augmentation index; ASDAS: Ankylosing Spondylitis Disease Activity Score; BMI: body mass index; CMAP: central mean arterial pressure; CRP: C-reactive protein; HDL-C: high-density lipoprotein cholesterol; NA: not applicable; NSAID: nonsteroidal antiinflammatory drugs; TC: total cholesterol; VO2peak: peak oxygen uptake; lnPWV: log-transformed pulse wave velocity.

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1 Nov 2018
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Associations Between Cardiorespiratory Fitness and Arterial Stiffness in Ankylosing Spondylitis: A Cross-sectional Study
Inger Jorid Berg, Anne Grete Semb, Silje H. Sveaas, Camilla Fongen, Désirée van der Heijde, Tore K. Kvien, Hanne Dagfinrud, Sella A. Provan
The Journal of Rheumatology Nov 2018, 45 (11) 1522-1525; DOI: 10.3899/jrheum.170726

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Associations Between Cardiorespiratory Fitness and Arterial Stiffness in Ankylosing Spondylitis: A Cross-sectional Study
Inger Jorid Berg, Anne Grete Semb, Silje H. Sveaas, Camilla Fongen, Désirée van der Heijde, Tore K. Kvien, Hanne Dagfinrud, Sella A. Provan
The Journal of Rheumatology Nov 2018, 45 (11) 1522-1525; DOI: 10.3899/jrheum.170726
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Keywords

ANKYLOSING SPONDYLITIS
CARDIORESPIRATORY FITNESS
ARTERIAL STIFFNESS

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