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Objectives. The aims of this study were to study physical activity (PA) in patients with RA by accelerometry and to determine to what degree their mobility is affected by disease activity.Methods. A group of 50 RA patients, without lower limb clinical disease, and 50 age- and sex-matched healthy controls were included in this cross-sectional study. PA was assessed by accelerometry and with the International Physical Activity Questionnaire (IPAQ). We performed multiple regression analysis not only to compare PA between groups, but also to explore the relation between RA features, including disease activity and cardiovascular risk parameters, and PA. In a randomized group of 30 RA patients a test–retest study was carried out in order to determine the correlation between variations in disease activity and PA.Results. The number of minutes of moderate and vigorous activity per day, as evaluated by accelerometry, was significantly lower in RA patients than in healthy controls. In RA patients, accelerometry and IPAQ demonstrated concordance to a moderate degree [quadratic weighed kappa index 0.27 (0.06–0.48), P = 0.02]. HAQ negatively correlated with both IPAQ and accelerometry data. The 28-joint DAS using CRP (DAS28-CRP) was also inversely related with IPAQ. Framingham score and metabolic syndrome were inversely associated with PA in RA patients. Interestingly, variations in PA by accelerometry inversely correlated with changes in RA disease activity (r = −0.42, P = 0.02).Conclusion. In RA patients, accelerometry is a reliable technique to evaluate PA. This study not only showed that RA patients spend less time doing moderate and vigorous PA than healthy controls, but also PA, as assessed by accelerometry, was sensitive to any changes in disease activity. [ABSTRACT FROM PUBLISHER]

Background: Tumor necrosis factor alpha (TNFα) may act as a link between inflammation and cardiovascular disease through several effects including the induction of insulin resistance (IR). The purpose of this study was to clarify if long-term modulation of inflammatory activity by TNFα inhibitors in RA patients has some influence on insulin sensitivity.Methods: Sixteen RA patients treated with anti-TNFα agents were followed during one year. Disease activity was assessed by DAS28, IR was determined by using Homeostatic Model Assessment-2, body composition was evaluated by impedance analysis, physical activity by accelerometry, abdominal fat distribution by magnetic resonance imaging, and serum level of key adipokines were quantified by ELISA.Results: Body mass indices were increased significantly after one year (25.71±3.20 vs 28.06±4.57 kg/m2, p=0.02) of treatment. Body composition interms of fat and fat-free mass had not changed except for a significant elevation of body cell mass (25.50±4.60 vs 26.60±3.17 kg, p=0.02). Values of visceral intraabdominal and subcutaneous abdominal adipose tissue were not modified. Levels of IR, beta cell production or insulin sensitivity did not change along the study. Basal levels of adiponectin, visfatin, leptin, ghrelin, resistin, and apelin did not change in response to anti-TNFα treatment; only retinol binding protein 4 showed a significant change (51.7±32.7 vs 64.9±28.4 μg/mL, p=0.03) at the end of the study.Conclusions: Insulin resistance, adiposity distribution, body composition, andserum levels of adipokines are not significantly affected by long-term inhibitionof TNFα in RA patients. Our findings question the suggested beneficial role ofanti-TNFα treatments in insulin resistance. [ABSTRACT FROM AUTHOR]