Work instability and associated factors among patients with rheumatoid arthritis in Greater Poland.

OBJECTIVES: Rheumatoid arthritis (RA) affects patients' capacity to work. The Rheumatoid Arthritis Work Instability Scale (RA-WIS) is a reliable method to measure work instability (WI) (1-3). We lack data on the relationship between RA and work instability among Polish patients. Our study aimed to assess WI and associated factors among patients with RA. MATERIAL AND METHODS: The authors conducted a multi-centre cross-sectional observational study. 315 patients from three rheumatology centres were enrolled and filled in questionnaires, including demographic and self-reported clinical data, RA-WIS, and the Health Assessment Questionnaire (HAQ). Swollen and tender joint counts (SJC, TJC) were assessed by the attending physician, and current erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were collected. We excluded 41 patients due to an incorrectly filled in form and analysed questionnaires of 274 patients. DAS28 (Disease Activity Score in 28 joints) and DAS28-CRP were calculated. We performed statistical analysis with Statistica v. 13.3 using the Mann-Whitney U test, χ2 test, and Spearman's correlation. RESULTS: 140 (51%) patients were currently employed and their characteristics were analysed. In univariable analysis we identified the following risk factors for high risk WI: moderate-to-high disease activity (DAS28 ≥ 3.2 - OR 2.29, 95% CI 1.06-4.96, p = 0.033; DAS28-CRP ≥ 3.2 - OR 2.34, 95% CI 1.04-5.27, p = 0.038), ESR ≥ 30 mm/h in women and ≥ 20 mm/h in men (OR 2.65, 95% CI 1.20-5.89, p = 0.010), CRP ≥ 1 mg/dl (OR 4.02, 95% CI 1.78-9.10, p < 0.001), HAQ-DI > 1.0 (OR 2.23, 95% CI 1.04-4.81, p = 0.037) and at least moderate pain on the visual analogue scale (VAS p ≥ 4.5 cm - OR 5.31, 95% CI 2.36-11.96, p < 0.001).Correlations were moderate between RA-WIS and VASp (RS = 0.59, p < 0.001) and HAQ-DI (RS = 0.52, p < 0.001) but weak with disease activity indices (DAS28 [RS = 0.31, p < 0.001]; DAS28-CRP [RS = 0.28, p < 0.001]). CONCLUSIONS: Pain and disability are the main factors strongly associated with work instability among patients with RA.

Arterial Stiffness Parameters Correlate with Estimated Cardiovascular Risk in Humans: A Clinical Study.

Arterial stiffness is said to be a novel predictor of cardiovascular events. This study investigated the correlation between arterial stiffness parameters and the estimated cardiovascular disease risk (RISK) in a Polish cohort of patients divided by age, sex, and body-mass index (BMI). The cross-sectional study enrolled 295 patients who met the inclusion criteria. Subjects were divided into three age groups, four weight groups, and by gender. The stiffness of the vessels was assessed by the measurement of the stiffness index (SI) and reflection index (RI). An individual 10-year RISK was calculated for each patient using the Heart Risk Calculator algorithm by the American Heart Association. A correlation between the SI and estimated RISK was observed (rS 0.42, p < 0.05). The strongest relationship was presented for women, the age group 40-54, and individuals with normal weight. The correlation between RI and calculated RISK was observed (rS 0.19, p < 0.05), the highest correlation was noticed for people aged 40-54 and obese. In conclusion, both SI and RI are correlated with estimated cardiovascular risk, however SI seems to be more useful than RI to predict the individual risk of future cardiovascular events. Both of these can be measured using non-invasive techniques, which demonstrates their potential utility in clinical practice.

The influence of meal frequency on lipid profile in the Polish population.

OBJECTIVES: Despite numerous investigations, the influence of meal frequency on the lipid profile has not been clearly determined. The aim of the study was to investigate whether meal frequency corresponds with the lipid profile. MATERIAL AND METHODS: The cross-sectional study enrolled 495 patients of University Hospital of Lord's Transfiguration who met inclusion criteria for study treated in 2015-2017. The subjects were divided according to meal frequency into a group consuming three or fewer meals a day and a group consuming four or more meals daily. To investigate whether there is a significant difference in cholesterol fractions and triglycerides concentrations between the mentioned groups the Mann Whitney U test was performed. RESULTS: The group included 495 patients (66.1% women, mean age 49.9 (SD=14.7) years). The median meal frequency was 4 per day. The frequency of consumed meals a day was significantly higher for women (median 4 meals per day) than for men (3 meals per day; p<0.0001). A significant difference in serum triglycerides concentrations between the mentioned groups was observed (p<0.0001). Similarly, the difference between HDL cholesterol concentrations was presented. (p<0.01). No significant difference in the serum concentrations of total cholesterol and LDL cholesterol between the group consuming 3 or fewer meals and the group consuming 4 or more meals daily was seen (p>0.05). CONCLUSION: We conclude that meal frequency equaling or higher than four meals daily is associated with lower fasting triglycerides and higher HDL cholesterol concentrations than consuming no more than three meals daily.