Effect of high-intensity interval training on cardiovascular disease risk factors and body composition in psoriatic arthritis: a randomised controlled trial

Ruth Stoklund Thomsen, Tom Ivar Lund Nilsen, Glenn Haugeberg, Anja Bye, Arthur Kavanaugh, Mari Hoff, Ruth Stoklund Thomsen, Tom Ivar Lund Nilsen, Glenn Haugeberg, Anja Bye, Arthur Kavanaugh, Mari Hoff

Abstract

Background: Psoriatic arthritis (PsA) is associated with an accumulation of cardiovascular disease (CVD) risk factors. The aim of this study was to evaluate the effect of high-intensity interval training (HIIT) on CVD risk factors in patients with PsA.

Methods: We randomly assigned 61 patients with PsA (41 women and 20 men) to an intervention group performing HIIT for 11 weeks or a control group who were instructed to not change their physical exercise habits. Outcomes were assessed at 3 and 9 months with measures on maximal oxygen uptake (VO2max), fat percentage and Body Mass Index (BMI). We used linear mixed models to calculate mean difference with 95% CI between the groups according to the intention-to-treat principle.

Results: At 3 months, the HIIT group had a 3.72 mL/kg/min (95% CI 2.38 to 5.06) higher VO2max and a 1.28 (95% CI -2.51 to -0.05) lower truncal fat percentage than controls. There was also some evidence that the HIIT group had lower total fat percentage (-0.80; 95% CI -1.71 to 0.10) and slightly lower BMI (-0.31; 95% CI -0.78 to 0.17) than the control group. At 9 months, the HIIT group had still a higher VO2max (3.08; 95% CI 1.63 to 4.53) than the control group, whereas the difference in other factors were small.

Conclusion: In patients with PsA, 3 months with HIIT was associated with a substantial increase in VO2max and a reduction in truncal fat percentage compared with controls. The beneficial effect on VO2max was also sustained through 9 months.

Trial registration number: NCT02995460.

Keywords: cardiovascular disease; psoriatic arthritis; treatment.

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Participant flow through the study. CT, control group; HIIT, high-intensity interval training; N, number of subjects; VO2max, maximum oxygen uptake.

References

    1. Gladman DD, Ang M, Su L, et al. . Cardiovascular morbidity in psoriatic arthritis. Ann Rheum Dis 2009;68:1131–5. 10.1136/ard.2008.094839
    1. Jamnitski A, Symmons D, Peters MJ, et al. . Cardiovascular comorbidities in patients with psoriatic arthritis: a systematic review. Ann Rheum Dis 2013;72:211–6. 10.1136/annrheumdis-2011-201194
    1. Eder L, Wu Y, Chandran V, et al. . Incidence and predictors for cardiovascular events in patients with psoriatic arthritis. Ann Rheum Dis 2016;75:1680–6. 10.1136/annrheumdis-2015-207980
    1. Gulati AM, Semb AG, Rollefstad S, et al. . On the HUNT for cardiovascular risk factors and disease in patients with psoriatic arthritis: population-based data from the Nord-Trøndelag Health Study. Ann Rheum Dis 2016;75:819–24. 10.1136/annrheumdis-2014-206824
    1. Polachek A, Touma Z, Anderson M, et al. . Risk of cardiovascular morbidity in patients with psoriatic arthritis: a meta-analysis of observational studies. Arthritis Care Res 2017;69:67–74. 10.1002/acr.22926
    1. Kodama S, Saito K, Tanaka S, et al. . Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women: a meta-analysis. JAMA 2009;301:2024–35. 10.1001/jama.2009.681
    1. Davidson T, Vainshelboim B, Kokkinos P, et al. . Cardiorespiratory fitness versus physical activity as predictors of all-cause mortality in men. Am Heart J 2018;196:156–62. 10.1016/j.ahj.2017.08.022
    1. Karlsen T, Aamot IL, Haykowsky M, et al. . High intensity interval training for maximizing health outcomes. Prog Cardiovasc Dis 2017;60:67–77. 10.1016/j.pcad.2017.03.006
    1. Nes BM, Janszky I, Aspenes ST, et al. . Exercise patterns and peak oxygen uptake in a healthy population: the HUNT study. Med Sci Sports Exerc 2012;44:1881–9. 10.1249/MSS.0b013e318258b443
    1. Wisløff U, Støylen A, Loennechen JP, et al. . Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation 2007;115:3086–94. 10.1161/CIRCULATIONAHA.106.675041
    1. Bacon AP, Carter RE, Ogle EA, et al. . VO2max trainability and high intensity interval training in humans: a meta-analysis. PLoS One 2013;8:e73182 10.1371/journal.pone.0073182
    1. Hagel S, Lindqvist E, Bremander A, et al. . Team-based rehabilitation improves long-term aerobic capacity and health-related quality of life in patients with chronic inflammatory arthritis. Disabil Rehabil 2010;32:1686–96. 10.3109/09638281003649946
    1. Iversen MD, Frits M, von Heideken J, et al. . Physical activity and correlates of physical activity participation over three years in adults with rheumatoid arthritis. Arthritis Care Res 2017;69:1535–45. 10.1002/acr.23156
    1. Turesson C, Matteson EL. Cardiovascular risk factors, fitness and physical activity in rheumatic diseases. Curr Opin Rheumatol 2007;19:190–6. 10.1097/BOR.0b013e3280147107
    1. Weston KS, Wisløff U, Coombes JS. High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysis. Br J Sports Med 2014;48:1227–34. 10.1136/bjsports-2013-092576
    1. Milanović Z, Sporiš G, Weston M. Effectiveness of high-intensity interval training (hit) and continuous endurance training for vo2max improvements: a systematic review and meta-analysis of controlled trials. Sports Med 2015;45:1469–81. 10.1007/s40279-015-0365-0
    1. Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: Updated guidelines for reporting parallel group randomised trials. Int J Surg 2011;9:672–7. 10.1016/j.ijsu.2011.09.004
    1. Larsson PU, Wadell KM, Jakobsson EJ, et al. . Validation of the MetaMax II portable metabolic measurement system. Int J Sports Med 2004;25:115–23. 10.1055/s-2004-819953
    1. Zisko N, Stensvold D, Hordnes-Slagsvold K, et al. . Effect of change in vo2max on daily total energy expenditure in a cohort of Norwegian men: a randomized pilot study. Open Cardiovasc Med J 2015;9:50–7. 10.2174/1874192401509010050
    1. Helgerud J, Høydal K, Wang E, et al. . Aerobic high-intensity intervals improve VO2max more than moderate training. Med Sci Sports Exerc 2007;39:665–71. 10.1249/mss.0b013e3180304570
    1. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377–81. 10.1249/00005768-198205000-00012
    1. Borg-scale , 1982.
    1. DiaGraphIT , 2015. GoTreatIT Rheuma software program.
    1. Andreoli A, Scalzo G, Masala S, et al. . Body composition assessment by dual-energy X-ray absorptiometry (DXA). Radiol Med 2009;114:286–300. 10.1007/s11547-009-0369-7
    1. Bea JW, Blew RM, Going SB, et al. . Dual energy X-ray absorptiometry spine scans to determine abdominal fat in postmenopausal women. Am J Hum Biol 2016;28:918–26. 10.1002/ajhb.22892
    1. Sveaas SH, Berg IJ, Provan SA, et al. . Efficacy of high intensity exercise on disease activity and cardiovascular risk in active axial spondyloarthritis: a randomized controlled pilot study. PLoS One 2014;9:e108688 10.1371/journal.pone.0108688
    1. Watad A, Cuthbert RJ, Amital H, et al. . Enthesitis: much more than focal insertion point inflammation. Curr Rheumatol Rep 2018;20:41 10.1007/s11926-018-0751-3
    1. Jacques P, Lambrecht S, Verheugen E, ResL C (Hoboken) S, et al. . Proof of concept: enthesitis and new bone formation in spondyloarthritis are driven by mechanical strain and stromal cells. Ann Rheum Dis 2014;73:437–45. 10.1136/annrheumdis-2013-203643
    1. Thomsen RS, Nilsen TIL, Haugeberg G, et al. . The impact of high intensity interval training on disease activity and patient disease perception in patients with psoriatic arthritis: a randomized controlled trial. Arthritis Care Res 2018. 10.1002/acr.23614
    1. Rognmo Ø, Hetland E, Helgerud J, et al. . High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil 2004;11:216–22. 10.1097/01.hjr.0000131677.96762.0c
    1. Sandstad J, Stensvold D, Hoff M, et al. . The effects of high intensity interval training in women with rheumatic disease: a pilot study. Eur J Appl Physiol 2015;115:2081–9. 10.1007/s00421-015-3186-9
    1. Aspenes ST, Nilsen TI, Skaug EA, et al. . Peak oxygen uptake and cardiovascular risk factors in 4631 healthy women and men. Med Sci Sports Exerc 2011;43:1465–73. 10.1249/MSS.0b013e31820ca81c
    1. Myers J, Kaminsky LA, Lima R, et al. . A reference equation for normal standards for VO2 max: analysis from the Fitness Registry and the Importance of Exercise National Database (FRIEND Registry). Prog Cardiovasc Dis 2017;60:21–9. 10.1016/j.pcad.2017.03.002
    1. Myers J, McAuley P, Lavie CJ, et al. . Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status. Prog Cardiovasc Dis 2015;57:306–14. 10.1016/j.pcad.2014.09.011
    1. Gulati M, Pandey DK, Arnsdorf MF, et al. . Exercise capacity and the risk of death in women: the St James Women Take Heart Project. Circulation 2003;108:1554–9. 10.1161/01.CIR.0000091080.57509.E9
    1. Williams PT. Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc 2001;33:754–61. 10.1097/00005768-200105000-00012
    1. Myers J, Kaykha A, George S, et al. . Fitness versus physical activity patterns in predicting mortality in men. Am J Med 2004;117:912–8. 10.1016/j.amjmed.2004.06.047
    1. Bagley L, Slevin M, Bradburn S, et al. . Sex differences in the effects of 12 weeks sprint interval training on body fat mass and the rates of fatty acid oxidation and VO2max during exercise. BMJ Open Sport Exerc Med 2016;2:e000056 10.1136/bmjsem-2015-000056
    1. Cao Y, Zhang S, Zou S, et al. . The relationship between endogenous androgens and body fat distribution in early and late postmenopausal women. PLoS One 2013;8:e58448 10.1371/journal.pone.0058448
    1. Xiao T, Fu YF. Resistance training vs. aerobic training and role of other factors on the exercise effects on visceral fat. Eur Rev Med Pharmacol Sci 2015;19:1779–84.
    1. Feld J, Nissan S, Eder L, et al. . Increased prevalence of metabolic syndrome and adipocytokine levels in a psoriatic arthritis cohort. J Clin Rheumatol 2018;24:302–7. 10.1097/RHU.0000000000000721
    1. Lee JJ, Pedley A, Hoffmann U, et al. . Association of changes in abdominal fat quantity and quality with incident cardiovascular disease risk factors. J Am Coll Cardiol 2016;68:1509–21. 10.1016/j.jacc.2016.06.067
    1. Gerdes S, Rostami-Yazdi M, Mrowietz U. Adipokines and psoriasis. Exp Dermatol 2011;20:81–7. 10.1111/j.1600-0625.2010.01210.x
    1. Scotece M, Conde J, Gómez R, et al. . Role of adipokines in atherosclerosis: interferences with cardiovascular complications in rheumatic diseases. Mediators Inflamm 2012;2012:125458–14. 10.1155/2012/125458
    1. Pischon T, Boeing H, Hoffmann K, et al. . General and abdominal adiposity and risk of death in Europe. N Engl J Med 2008;359:2105–20. 10.1056/NEJMoa0801891
    1. Jacquemin C, Servy H, Molto A, et al. . Physical activity assessment using an activity tracker in patients with rheumatoid arthritis and axial spondyloarthritis: prospective observational study. JMIR Mhealth Uhealth 2018;6:e1 10.2196/mhealth.7948
    1. Katz P, Margaretten M, Gregorich S, et al. . Physical activity to reduce fatigue in rheumatoid arthritis: a randomized controlled trial. Arthritis Care Res 2018;70:1–10. 10.1002/acr.23230
    1. Tjønna AE, Leinan IM, Bartnes AT, et al. . Low- and high-volume of intensive endurance training significantly improves maximal oxygen uptake after 10-weeks of training in healthy men. PLoS One 2013;8:e65382 10.1371/journal.pone.0065382
    1. Michelsen B, Fiane R, Diamantopoulos AP, et al. . A comparison of disease burden in rheumatoid arthritis, psoriatic arthritis and axial spondyloarthritis. PLoS One 2015;10:e0123582 10.1371/journal.pone.0123582
    1. Desthieux C, Granger B, Balanescu AR, et al. . Determinants of patient–physician discordance in global assessment in psoriatic arthritis: a multicenter European study. Arthritis Care Res 2017;69:1606–11. 10.1002/acr.23172

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa