Relative importance of inflammation and cardiorespiratory fitness for all-cause mortality risk in persons with rheumatoid arthritis: the population-based Trøndelag Health Study
Authors' conclusion
Even with CRP concentrations <3 mg/L in all patients with RA, excess mortality mediated by low CRF would still play an important role.
Study context
- Population
- Participants of the third survey of the Trøndelag Health Study (HUNT3, 2006–2008), Norway
- Participants
- 223 vs 31,684
- Exposure
- Persons with rheumatoid arthritis (RA) vs persons without RA
- Casesn = 223
- Controlsn = 31,684reference
- Outcome
- All-cause mortality (Norwegian Cause of Death Registry), with mediation by inflammation (CRP) and eCRF
- Follow-up
- Until death or 31 December 2018
Methodological detailsmediation analysis, standardised equation modelling, registry linkage
- Mediation analysis
- Standardised equation modelling
- Registry linkage
Main finding
As reported in the abstract
All-cause mortality
P < 0.001
Observational data: associations, not effects.
Further findings
Mediation of excess mortality in RA by estimated CRF (eCRF) and C reactive protein (CRP) ≥3 mg/L
- eCRF a mediator of excess mortality
- P < 0.001
- CRP ≥3 mg/L a mediator of excess mortality
- P < 0.001
- Direct effect of RA (non-significant)
- P = 0.19
- Indirect effect of RA mediated by eCRF, standardised coefficient
- 0.006
- Indirect effect of RA mediated by CRP, standardised coefficient
- 0.002
- Indirect effect via eCRF approximately three times higher than via CRP
- Model adjusted for other mortality risk factors
Original publication
Relative importance of inflammation and cardiorespiratory fitness for all-cause mortality risk in persons with rheumatoid arthritis: the population-based Trøndelag Health Study. RMD Open. Published 8 August 2023. doi:10.
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