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Association between daily level of objective physical activity and C-Reactive protein in a representative national sample of adults with self-reported diagnosed arthritis or fibromyalgia

Abstract

Purpose

Examine the association between physical activity and sedentary time with high sensitivity C-Reactive protein levels in adults with arthritis and fibromyalgia. We also investigated the dose of physical activity that was associated with lower clinical levels of high sensitivity C-Reactive protein (< 3 mg/L).

Materials and methods

Observational design was used to evaluate the variables of interest-based on the Canadian Health Measures Survey cycle 1–3 (2007–2012). Generalized adjusted additive models were used to explore the shape of the association between high sensitivity C-Reactive protein, daily physical activity, step count and sedentary time. High sensitivity C-Reactive protein was measured with blood samples. Physical activity, number of steps and sedentary time were objectively assessed using an Actical accelerometer.

Results

Daily moderate to vigorous physical activity and step count were significantly associated with lower high sensitivity C-Reactive protein levels, but daily light physical activity and sedentary time were not associated with high sensitivity C-Reactive protein levels, even after controlling for age, sex, daily smoking, body mass index, household income, level of education levels, marital status, work year and accelerometer wear time and season of accelerometer. Non-linear dose–response patterns were observed between daily moderate to vigorous physical activity as well as step count with high sensitivity C-Reactive protein levels. Lower high sensitivity C-Reactive protein levels were associated with 1–150 min of daily moderate to vigorous physical activity and with daily step count starting at 4000 in people with arthritis. Adults with fibromyalgia had lower levels of high sensitivity C-Reactive protein when engaging in 10–35 min of daily moderate to vigorous physical activity and in 5000–9000 daily steps. Optimal and specific doses of daily moderate to vigorous physical activity and steps were independently related to lower high sensitivity C-Reactive protein levels in adults with arthritis and fibromyalgia.

Conclusions

Daily moderate to vigorous physical activity and step count were associated with high sensitivity C-Reactive protein levels that were below the clinical threshold. Given the positive outcomes of physical activity on health, adults with arthritis and fibromyalgia may benefit from these specific recommendations.

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References

  1. Lacativa PGS, de Farias MLF (2010) Osteoporosis and inflammation. Arq Bras Endocrinol Metabol 54:123–132. https://doi.org/10.1590/S0004-27302010000200007

    Article  PubMed  Google Scholar 

  2. Nowakowski AC (2014) Chronic inflammation and quality of life in older adults: a cross-sectional study using biomarkers to predict emotional and relational outcomes. Health Qual Life Outcomes. https://doi.org/10.1186/s12955-014-0141-0

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sluka KA, Clauw DJ (2016) Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience 338:114–129. https://doi.org/10.1016/j.neuroscience.2016.06.006

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Gavrilă B, Ciofu C, Stoica V (2016) Biomarkers in rheumatoid arthritis, what is new? J Med Life 9:144–148

    PubMed  PubMed Central  Google Scholar 

  5. Kourilovitch M, Galarza-Maldonado C, Ortiz-Prado E (2014) Diagnosis and classification of rheumatoid arthritis. J Autoimmun 48–49:26–30. https://doi.org/10.1016/j.jaut.2014.01.027

    Article  CAS  PubMed  Google Scholar 

  6. Feinberg T, Sambamoorthi U, Lilly C, Innes KK (2017) Potential mediators between fibromyalgia and C-Reactive protein: results from a large US community survey. BMC Musculoskelet Disord 18:294. https://doi.org/10.1186/s12891-017-1641-y

    Article  PubMed  PubMed Central  Google Scholar 

  7. Lund Håheim L, Nafstad P, Olsen I et al (2009) C-reactive protein variations for different chronic somatic disorders. Scand J Public Health 37:640–646. https://doi.org/10.1177/1403494809104358

    Article  PubMed  Google Scholar 

  8. Pepys MB, Hirschfield GM (2003) C-reactive protein: a critical update. J Clin Invest 111:1805–1812. https://doi.org/10.1172/JCI200318921

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Arnold LM, Clauw DJ, McCarberg BH (2011) Improving the recognition and diagnosis of fibromyalgia. Mayo Clin Proc 86:457–464. https://doi.org/10.4065/mcp.2010.0738

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bazzichi L, Rossi A, Massimetti G et al (2007) Cytokine patterns in fibromyalgia and their correlation with clinical manifestations. Clin Exp Rheumatol 25:225–230

    CAS  PubMed  Google Scholar 

  11. Rus A, Molina F, Gassó M et al (2016) Nitric oxide, inflammation, lipid profile, and cortisol in normal- and overweight women with fibromyalgia. Biol Res Nurs 18:138–146. https://doi.org/10.1177/1099800415591035

    Article  CAS  PubMed  Google Scholar 

  12. Loprinzi PD (2015) Frequency of moderate-to-vigorous physical activity (MVPA) is a greater predictor of systemic inflammation than total weekly volume of MVPA: Implications for physical activity promotion. Physiol Behav 141:46–50. https://doi.org/10.1016/j.physbeh.2015.01.002

    Article  CAS  PubMed  Google Scholar 

  13. Parsons TJ, Sartini C, Welsh P et al (2017) Physical activity, sedentary behavior, and inflammatory and hemostatic markers in men. Med Sci Sports Exerc 49:459–465. https://doi.org/10.1249/MSS.0000000000001113

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Ford E (2002) Does exercise reduce inflammation? Physical activity and C-reactive protein among U.S. adults. Epidemiology 12:561–568. https://doi.org/10.1097/01.EDE.0000023965.92535.C0

    Article  Google Scholar 

  15. McFarlin BK, Flynn MG, Campbell WW et al (2006) Physical activity status, but not age, influences inflammatory biomarkers and toll-like receptor 4. J Gerontol A Biol Sci Med Sci 61:388–393. https://doi.org/10.1093/gerona/61.4.388

    Article  PubMed  Google Scholar 

  16. Yates T, Khunti K, Wilmot EG et al (2012) Self-reported sitting time and markers of inflammation, insulin resistance, and adiposity. Am J Prev Med 42:1–7. https://doi.org/10.1016/j.amepre.2011.09.022

    Article  PubMed  Google Scholar 

  17. Henson J, Yates T, Edwardson CL et al (2013) Sedentary time and markers of chronic low-grade inflammation in a high risk population. PLoS ONE 8:e78350. https://doi.org/10.1371/journal.pone.0078350

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Tremblay MS, Gorber SC (2007) Canadian health measures survey: brief overview. Can J Public Health Rev Can Sante Publique 98:453–456

    Article  Google Scholar 

  19. Tremblay M, Wolfson M, Gorber SC (2007) Canadian Health Measures Survey: Rationale, background and overview. Health Reports Statistics Canada 82-003:7–19. https://www150.statcan.gc.ca/n1/pub/82-003-s/2007000/article/10361-eng.pdf

  20. Day B, Langlois R, Tremblay M, Knoppers B-M (2007) Canadian Health Measures Survey: Ethical, legal and social issues. Health Reports Statistics Canada 82-003:37–51. https://www150.statcan.gc.ca/n1/pub/82-003-s/2007000/article/10364-eng.pdf

  21. Colley RC, Tremblay MS (2011) Moderate and vigorous physical activity intensity cut-points for the Actical accelerometer. J Sports Sci 29:783–789. https://doi.org/10.1080/02640414.2011.557744

    Article  PubMed  Google Scholar 

  22. Giroux S (2007) Canadian Health Measures Survey: Sampling strategy overview. Health Reports Statistics Canada 82-003:31–56. https://www150.statcan.gc.ca/n1/en/catalogue/82-003-S200700010363

  23. Statistics Canada Canadian Health Measures Survey (Cycle 3) - Household Questionnaire. https://www.statcan.gc.ca/eng/statistical-programs/instrument/5071_Q1_V3

  24. Bryan S, St-Denis M, Wojtas D Canadian Health Measures Survey: Clinic operations and logistics. 18:19

  25. Esliger DW, Probert A, Gorber SC et al (2007) Validity of the actical accelerometer step-count function. Med Sci Sports Exerc 39:1200–1204. https://doi.org/10.1249/mss.0b013e3804ec4e9

    Article  PubMed  Google Scholar 

  26. Kasapis C, Thompson PD (2005) The effects of physical activity on serum C-reactive protein and inflammatory markers. J Am Coll Cardiol 45:1563–1569. https://doi.org/10.1016/j.jacc.2004.12.077

    Article  CAS  PubMed  Google Scholar 

  27. Prioreschi A, Hodkinson B, Avidon I et al (2013) The clinical utility of accelerometry in patients with rheumatoid arthritis. Rheumatology 52:1721–1727. https://doi.org/10.1093/rheumatology/ket216

    Article  PubMed  Google Scholar 

  28. Statistics Canada (2010) Quality control and data reduction procedures for accelerometry-derived measures of physical activity. Health Rep 21:63–69

    Google Scholar 

  29. Troiano RP, Berrigan D, Dodd KW et al (2008) Physical activity in the united states measured by accelerometer. Med Sci Sports Exerc 40:181–188. https://doi.org/10.1249/mss.0b013e31815a51b3

    Article  PubMed  Google Scholar 

  30. Wood SN (2006) Generalized additive models: an introduction with R. Chapman & Hall/CRC, Boca Raton

    Book  Google Scholar 

  31. Zajacova A, Dowd JB, Burgard SA (2011) Overweight adults may have the lowest mortality—do they have the best health? Am J Epidemiol 173:430–437. https://doi.org/10.1093/aje/kwq382

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bauman AE, Reis RS, Sallis JF et al (2012) Correlates of physical activity: why are some people physically active and others not? The Lancet 380:258–271. https://doi.org/10.1016/S0140-6736(12)60735-1

    Article  Google Scholar 

  33. Kirk MA, Rhodes RE (2011) Occupation correlates of adults’ participation in leisure-time physical activity. Am J Prev Med 40:476–485. https://doi.org/10.1016/j.amepre.2010.12.015

    Article  PubMed  Google Scholar 

  34. On behalf of the DEDIPAC consortium, O’Donoghue G, Perchoux C et al (2016) A systematic review of correlates of sedentary behaviour in adults aged 18–65 years: a socio-ecological approach. BMC Public Health 16:163. https://doi.org/10.1186/s12889-016-2841-3

    Article  PubMed Central  Google Scholar 

  35. Katapally TR, Muhajarine N (2014) Towards uniform accelerometry analysis: a standardization methodology to minimize measurement bias due to systematic accelerometer wear-time variation. J Sports Sci Med 13:8

    Google Scholar 

  36. Lumley TS (2010) Complex Surveys: A Guide to Analysis Using R. John Wiley, Hoboken, NJ, USA

    Book  Google Scholar 

  37. Degano C, Nichol M, Walsh P, Lange A (2010) Life with arthritis in Canada: A personal and public health challenge. Public Health Agency of Canada. https://www.canada.ca/en/public-health/services/chronic-diseases/arthritis/life-arthritis-canada-a-personal-public-health-challenge.html

  38. Statistics Canada (2016) Canadian Community Health Survey, 2014: Annual Component. http://www.cchs-82M0013-E-2014-Annual-component

  39. Myers GL, Rifai N, Tracy RP et al (2004) CDC/AHA workshop on markers of inflammation and cardiovascular disease: application to clinical and public health practice: report from the laboratory science discussion group. Circulation. https://doi.org/10.1161/01.CIR.0000148980.87579.5E

    Article  PubMed  Google Scholar 

  40. Bernard P, Hains-Monfette G, Atoui S, Kingsbury C (2018) Differences in daily objective physical activity and sedentary time between women with self-reported fibromyalgia and controls: results from the Canadian health measures survey. Clin Rheumatol 37:2285–2290. https://doi.org/10.1007/s10067-018-4139-6

    Article  PubMed  Google Scholar 

  41. Dale LP, LeBlanc AG, Orr K et al (2016) Canadian physical activity guidelines for adults: are Canadians aware? Appl Physiol Nutr Metab 41:1008–1011. https://doi.org/10.1139/apnm-2016-0115

    Article  PubMed  Google Scholar 

  42. O’Connor SR, Tully MA, Ryan B et al (2015) Walking exercise for chronic musculoskeletal pain: systematic review and meta-analysis. Arch Phys Med Rehabil 96:724–734.e3. https://doi.org/10.1016/j.apmr.2014.12.003

    Article  PubMed  Google Scholar 

  43. Munsterman T, Takken T, Wittink H (2012) Are persons with rheumatoid arthritis deconditioned? A review of physical activity and aerobic capacity. BMC Musculoskelet Disord 13:202. https://doi.org/10.1186/1471-2474-13-202

    Article  PubMed  PubMed Central  Google Scholar 

  44. Coskun Benlidayi I (2019) Role of inflammation in the pathogenesis and treatment of fibromyalgia. Rheumatol Int 39:781–791. https://doi.org/10.1007/s00296-019-04251-6

    Article  CAS  PubMed  Google Scholar 

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Acknowledgement

The authors would like to thank the participants of the Canadian Health Measures Survey as well as all staff at Statistics Canada involved in the operations of the survey.

Funding

The authors report no financial conflicts of interest. Celia Kingsbury is supported by the Canadian Institutes of Health Research: Undergraduate: Summer Studentship Award (2019). Paquito Bernard is supported by a salary award from the Fonds de recherche du Québec–Santé. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.

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Authors

Contributions

CK and PB conceived the study. PB and GH-M provided statistical expertise in the complex survey. GH-M and CK conducted the primary statistical analyses. GH-M and CK wrote the Results section. CK, AK and PB wrote the other sections. All authors contributed to the refinement of the study protocol and approved the final manuscript.

Corresponding author

Correspondence to Celia Kingsbury.

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Conflicts of interest

Kingsbury C Karelis A, Hains-Monfette G, and Bernard P declare that they have no conflicts of interest.

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Kingsbury, C., Karelis, A., Hains-Monfette, G. et al. Association between daily level of objective physical activity and C-Reactive protein in a representative national sample of adults with self-reported diagnosed arthritis or fibromyalgia. Rheumatol Int 40, 1463–1471 (2020). https://doi.org/10.1007/s00296-020-04571-y

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Keywords

  • Rheumatology
  • Fibromyalgia
  • Inflammation
  • Physical exercise
  • Canadian sample