Objectives: There is evidence that calcium, magnesium, vitamin D, proteins, antioxidants and w-3 fatty acids intakes are inversely associated with risk of osteoporosis and hip fractures.In the present study we examine the association of food consumption pattern and w-6/w-3 fatty acid ratio of the diet with hip joint fractures.Methods: Sixty cases having fracture neck of femur and 95 control subjects above 50 years of age were included in this case control study.Dietary intakes were obtained by 3 days assessment of food intakes by questionnaires among patients with fractures(n=50) as well as among 95 control subjects.Physical activity was assessed by questionnaires.Radiological and clinical examination were conducted for the diagnosis of fractures.Cytokines were measured by chemoluminescence enzyme immunometric assay (immulite automated analyzer) kit (DPC Los Angelis, CA, USA).Regression analysis was done to find out the association of risk factors with hip fractures.Results: Among 60 cases, the fracture was more common in male than female.Fruits, vegetables and legume(165 ±12.6 vs. 205±15.8g/day,P<0.03) as well as milk products (milk, curd, butter etc) consumption (205+25.8 vs. 318±31.5g/day,P<0.05)were significantly lower and w-6 rich oils intake was significantly higher among patients with fractures compared to control subjects, respectively.Omega-3 fatty acids intakes were significantly lower among patients with fractures (0.45± 0.74 g/day, P<0.05).Osteoporosis (92.0%), trivial trauma (92.0%), physical inactivity (80.0%), diabetes mellitus(21.6%)were common among patients with hip fracture.Multivariate logistic regression analysis showed that the intakes of fruit, vegetable and legume ( odds ratio 1.12, confidence interval (CI) 1.02-1.21,P<0.05), physical activity(OR 1.36, CI 1.22-1.52,P<0.05), w-3 fatty acids (OD1.05,0.92-1.17,P<0.01) intake were inversely associated with fracture, whereas w-6/w-3 ratio (OD 1.33, CI 1.18-1.47,P<0.01)interleukin-6, (OD1.11,CI 1.02-1.19,P<0.01), tumor necrosis factor-alpha(OD,1.09,CI 1.01-1.17,P<0.01) were positively associated with fracture. Conclusion:This study showed that increased consumption of fruit, vegetable and legume, milk products and w-3 fatty acid and low w-6/w-3 ratio diet as well as physical activity may be protective against hip joint fractures.
Background There are few studies detailing the prevalence of prehypertension and hypertension in India.Methods Men and women, over 25 years of age were included. After completion of a dietitian-administered questionnaire followed evaluation by a physician, physical examination and blood pressure measurement. Cross-sectional survey screened 6940 subjects, (3507 men (M), 3433 women (W): 1993-96) from cities located in five corners of India (Kolkata, n = 900; Nagpur, n = 894; Mumbai, n = 1542; Thiruanantpuram, n = 1602; Moradabad, n = 2002). Prehypertension (BP 130-139/85-89 mm Hg) and hypertension (BP ≥ 140/90 mm Hg) were diagnosed according to the European Society of Cardiology criteria.Results Prevalence of prehypertension and hypertension, respectively, was significantly greater in South India (Trivandrum: W 31.5; 31.9%; M 35.1; 35.5%) and West India (Mumbai: W 30.0; 29.1%; M 34.7; 35.6%) compared to North India (Moradabad: W 24.6; 24.5%; M 26.7; 27.0%) and East India (Kolkata: W 20.9; 22.4%; M 23.5; 24.0%). Subjects with prehypertension and hypertension were older, had a higher BMI, central obesity and a sedentary lifestyle. They had a higher salt and alcohol intake, with greater oral contraceptive usage (W). Multivariable logistic regression analysis revealed strong positive associations of hypertension with age, central obesity, BMI, sedentary lifestyle, salt and alcohol intake and oral contraceptive usage (W). Fruit, vegetable and legume intake showed inverse associations, tobacco intake showed none. One in four with hypertension was aware of their diagnosis and of those receiving treatment, one in three had well-controlled hypertension.Conclusions There is little awareness that prehypertension and hypertension are public health issues in India. Ageing population, central obesity, sedentary lifestyle, excessive salt and alcohol, lower fruit, vegetable and legumes intake increase risk for blood pressure elevation.
Despite efficient biological disease-modifying antirheumatic drugs (bDMARDs) Rheumatoid Arthritis (RA) patients still suffer from high fatigue. This study aims to further our knowledge by assessing severity levels of the various fatigue dimensions and their associations with pain, sleep quality, and psychological well-being in bDMARDs treated RA patients.
Abstract Objectives Although evidence is accumulating globally, data on outcomes in rheumatic disease and COVID-19 in Ireland are limited. We used data from the COVID-19 Global Rheumatology Alliance (C19-GRA) to describe time-varying COVID-19 outcomes for people with rheumatic disease in Ireland. Methods Data entered into the C19-GRA provider registry from Ireland between 24 March 2020 and 9 July 2021 were analysed. Differences in the likelihood of hospitalization and mortality according to demographic and clinical variables were investigated using Chi-squared test or Fisher’s exact test, as appropriate. Trends in odds of hospitalization and mortality over time were investigated using logistic regression with the time period as a categorical variable. Results Of 212 cases included, 59.4% were female and median age was 58.0 years (range 13–96). Of the 212 cases, 92 (43%) were hospitalized and 22 (10.4%) died. Increasing age, a diagnosis of gout, ever smoking, glucocorticoid use, having comorbidities and specific comorbidities of cancer, cardiovascular and pulmonary disease were more common in those hospitalized. A diagnosis of inflammatory arthritis, csDMARD and/or b/tsDMARD use were less frequent in those hospitalized. Increasing age, a diagnosis of gout, ever smoking, having comorbidities and specific comorbidities of obesity, cardiovascular and pulmonary disease were more common in those who died. Odds of hospitalization or mortality did not change over time. Conclusion No temporal trend was observed in either COVID-19-related hospitalization or mortality outcomes for people with rheumatic disease in Ireland.
Background
Fatigue is one of the most prevalent and yet neglected symptoms in Rheumatoid Arthritis (RA). Little attention has been paid to the multidimensional nature of fatigue and its wide-ranging consequences for functional status and quality of life. RA-related fatigue appears to be strongly associated with psychosocial factors. Therefore, the aim of this study was to assess the associations between fatigue, functional status, and self-esteem in RA patients.
Methods
The sample consisted of 297 RA patients (80.8% female; mean age 56.03 ± 11.57 years). All patients completed the Health Assessment Questionnaire (HAQ), the Rosenberg Self-Esteem Scale (RSE) and the Visual Analogue Scale - Fatigue (VAS). Multiple linear regressions were used for statistical analyses.
Findings
Sociodemographic (age, gender, education) and clinical variables (C-reactive protein, ESR, disease duration) explained 5% of total variance in fatigue. When HAQ (functional status) was added a 10% boost was achieved. Self-esteem explained additional 7% of the total variance in fatigue.
Discussion
Lower self-esteem was found to be significantly associated with fatigue in RA patients. This result suggests that fatigue may interfere with the way in which RA patients see and value themselves. Caregivers and physicians can encourage patients to use various strategies to enhance self-esteem in order to mitigate the negative effects of fatigue on health and quality of life in RA patients.
[Grant support: APVV-15-0719]
Introduction: The objective of the study was to investigate the course of psychological distress in early rheumatoid arthritis patients and to explore the strength of its associations with disease-related variables over time. A further aim focused specifically on the associations between social support and psychological distress. Methods: The study had a longitudinal design, with four annual measurements over consecutive years. The course and stability of psychological distress on the individual level were investigated via test–retest correlation coefficients and changes over time were studied using the Friedman test for repeated measurements. Hierarchical regression analysis was performed to analyze the multilinear associations of disease activity, functional disability, joint tenderness, pain and social support with psychological distress. Results: Significant cross-sectional associations were found among functional disability, joint tenderness, pain, emotional support, instrumental support and psychological distress. However, after controlling for the erratic pattern of the disease and the relevant variables, only initial psychological distress and emotional support retained a significant relationship with psychological distress. The final regression model, in which functional disability, pain, emotional support and initial psychological distress were significant variables, explained 36% of the variance in psychological distress. Conclusion: The study stresses the importance of initial psychological distress, which was found to have the highest correlation with psychological distress experienced 4 years later. In addition, higher emotional support and lower pain were found to be the only variables independently associated with lower levels of psychological distress after controlling for the relevant variables.Implications for RehabilitationPsychological distress is a relevant problem in rheumatoid arthritis patients and should be recognized early in the disease as it might reflect a lack of social resources which can be crucial in the further course of the disease.Special attention should be paid to different types of social support in relation to psychological distress, which might improve targeting psychosocial interventions.
Social participation is an important aspect associated with health-related outcomes in chronic diseases. However, little is known about the factors that may affect participation in patients with rheumatoid arthritis (RA). We aimed to examine whether pain, fatigue, anxiety, depression, and illness perception are associated with social participation in patients with RA when controlled for clinical and sociodemographic variables. We also analysed the mediating role of illness perception in the association between physical and psychological variables on social participation.
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