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Södergren, Anna
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Publications (10 of 26) Show all publications
Ångström, L., Hörnberg, K., Sundström, B., Wållberg Jonsson, S. & Södergren, A. (2020). Aerobic capacity is associated with disease activity and cardiovascular risk factors in early rheumatoid arthritis. Physiotherapy Research International, Article ID e1833.
Open this publication in new window or tab >>Aerobic capacity is associated with disease activity and cardiovascular risk factors in early rheumatoid arthritis
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2020 (English)In: Physiotherapy Research International, ISSN 1358-2267, E-ISSN 1471-2865, article id e1833Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objectives: The aim of this study was to investigate aerobic capacity and its associations with disease activity and risk factors for cardiovascular disease (CVD) in early rheumatoid arthritis (RA).

Methods: This cross‐sectional study included 67 patients with early RA. Aerobic capacity was estimated with the Åstrand submaximal test adjusted according to the Nord‐Tröndelag Health Study formula. The following were also assessed: subclinical atherosclerosis by carotid intima‐media thickness and pulse wave analysis; body composition by dual X‐ray absorptiometry; estimated CVD mortality risk by the Systematic Coronary Risk Evaluation; disease activity by the Disease Activity Score 28, C‐reactive protein and erythrocyte sedimentation rate; blood lipids by total cholesterol, low‐density lipoproteins, high‐density lipoproteins, and triglycerides; and functional ability by the Stanford health assessment questionnaire. Univariate and multiple linear regression analyses were performed to explore the associations between variables.

Results: The mean (SD) aerobic capacity was 31.6 (8.7) ml O2−1 kg min−1. Disease activity and risk factors for CVD were more favourable for patients with aerobic capacity above the median value. Aerobic capacity was associated with ESR and several CVD risk factors, independent of age and sex. In a multiple regression model that was adjusted for age and sex, aerobic capacity was significantly associated with per cent body fat (β = −0.502, 95% CI [−0.671, −0.333]) and triglycerides (β = −2.365, 95% CI [−4.252, −0.479]).

Conclusions: Disease activity and risk factors for CVD were in favour for patients with a higher aerobic capacity. Aerobic capacity was associated with disease activity and several risk factors for CVD, independent of age and sex. In RA, these findings may provide insights into the benefits of using aerobic capacity as a marker to prevent CVD.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
aerobic capacity, disease activity, cardiovascular disease, rheumatoid arthritis
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-164590 (URN)10.1002/pri.1833 (DOI)000506078500001 ()31913553 (PubMedID)
Note

First published in thesis in manuscript form with title: "Aerobic capacity is associated with cardiovascular risk factors and disease activity in early rheumatoid arthritis : a cross sectional study"

Available from: 2019-10-24 Created: 2019-10-24 Last updated: 2020-02-04
Södergren, A., Karp, K., Bengtsson, C., Möller, B., Rantapää-Dahlqvist, S. & Wållberg-Jonsson, S. (2019). Biomarkers associated with cardiovascular disease in patients with early rheumatoid arthritis. PLoS ONE, 14(8), Article ID e0220531.
Open this publication in new window or tab >>Biomarkers associated with cardiovascular disease in patients with early rheumatoid arthritis
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2019 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 8, article id e0220531Article in journal (Refereed) Published
Abstract [en]

Objectives: Patients with rheumatoid arthritis (RA) have an increased mortality and morbidity due to cardiovascular disease (CVD). In this prospective 5-year follow up of patients with RA, we analysed several biomarkers, known to be associated with atherosclerosis and/or inflammation in the general population. The aim of this study was to find out whether the RA-disease per se affect these biomarkers and if those could be associated with the progression of atherosclerosis, as measured by intima media thickness (IMT) among patients with early RA.

Methods: Patients from northern Sweden diagnosed with early RA, are consecutively recruited into an ongoing prospective study on CVD comorbidity. A subgroup of patients, aged ≤60 years (n = 71) was included for ultrasound measurements of IMT at inclusion (T0) and after 5 years (T5) together with age-sex-matched controls (n = 40). The patients were clinically assessed. Blood was analysed for lipids, ESR and CRP and several biomarkers known to be associated with atherosclerosis in the general population.

Results: At T0, the patients with RA had significantly lower levels of MIF and significantly higher levels of interleukin (IL)-18 and MIC-1 compared with controls. At T5, the patients with RA had significantly higher levels of pentraxin3, MIC-1, TNF-R2, ICAM-1, VCAM-1 and endostatin compared with controls. At T0 the levels of MPO correlated with DAS28, sCD40L with CRP and IL-18 with systolic blood pressure and Reynolds risk score. Using PLSR on a CVD-panel analysed with multiplex immunoassay, the patients with RA could be correctly classified into those who had a worsening in their IMT over the five years or not. Here, MMP3 was identified as influential.

Conclusions: This study indicates that the RA disease itself could affect several of the biomarkers in this study, and possibly also the processes involved in the development of atherosclerosis.

Place, publisher, year, edition, pages
Public Library of Science, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-164650 (URN)10.1371/journal.pone.0220531 (DOI)000484993600022 ()31381601 (PubMedID)2-s2.0-85070281863 (Scopus ID)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-10-25Bibliographically approved
Hörnberg, K., Pomeroy, J., Sandberg, C., Södergren, A., Ångström, L., Sundström, B. & Wållberg-Jonsson, S. (2019). Physical activity in rheumatoid arthritis: relationship to cardiovascular risk factors, subclinical atherosclerosis, and disease activity. Scandinavian Journal of Rheumatology
Open this publication in new window or tab >>Physical activity in rheumatoid arthritis: relationship to cardiovascular risk factors, subclinical atherosclerosis, and disease activity
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2019 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732Article in journal (Refereed) Epub ahead of print
Abstract [en]

Objective: To investigate associations between physical activity and risk factors for cardiovascular disease (CVD), subclinical atherosclerosis, and disease activity in patients with early and long-standing rheumatoid arthritis (RA).

Method: This cross-sectional study included 84 patients with early and 37 with long-standing RA (disease duration, mean ± sd: 1.4 ± 0.4 and 16.3 ± 2.3 years, respectively). Physical activity was measured using a combined accelerometer and heart-rate monitor. Further assessments were disease activity (erythrocyte sedimentation rate, Disease Activity Score in 28 joints), functional ability (Health Assessment Questionnaire), risk factors for CVD (blood lipids, i.e. triglycerides, high-density lipoprotein, low-density lipoprotein; blood glucose, blood pressure, sleeping heart rate, waist circumference, body mass index, and body fat), and subclinical atherosclerosis (pulse-wave velocity, augmentation index, and carotid intima–media thickness).

Results: Physical activity variables did not differ between patients with early and long-standing RA. However, 37% of the patients with early and 43% of those with long-standing RA did not reach the World Health Organization’s recommended levels of moderate to vigorous physical activity (MVPA). In a final multiple regression model, adjusted for age, gender, disease duration, and activity monitor wear time, higher total physical activity was associated with lower body fat and higher functional ability. With the same adjustments, more time spent in MVPA was associated with lower high-density lipoprotein and lower sleeping heart rate.

Conclusions: Physical activity was associated with more favourable risk factors for CVD. However, many patients were physically inactive, stressing the importance of promoting physical activity in RA.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-167099 (URN)10.1080/03009742.2019.1657491 (DOI)000499749300001 ()31739706 (PubMedID)
Funder
King Gustaf V Jubilee FundVästerbotten County Council
Available from: 2020-01-09 Created: 2020-01-09 Last updated: 2020-01-09
Södergren, A., Askling, J., Bengtsson, K., Forsblad-d'Elia, H., Jernberg, T., Lindström, U., . . . Jacobsson, L. T. (2018). Case fatality over 365 days after first acute coronary syndrome in patients with ankylosing spondylitis. Paper presented at Congress of the European-League-Against-Rheumatism (EULAR), JUN 13-16, 2018, Amsterdam, NETHERLANDS. Annals of the Rheumatic Diseases, 77, 341-341
Open this publication in new window or tab >>Case fatality over 365 days after first acute coronary syndrome in patients with ankylosing spondylitis
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, p. 341-341Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-152909 (URN)000444351001050 ()
Conference
Congress of the European-League-Against-Rheumatism (EULAR), JUN 13-16, 2018, Amsterdam, NETHERLANDS
Note

Supplement: 2

Meeting Abstract: THU0243

Available from: 2018-10-30 Created: 2018-10-30 Last updated: 2018-10-30Bibliographically approved
Bjorsenius, I., Rantapää-Dahlqvist, S., Wållberg-Jonsson, S. & Södergren, A. (2018). Increased progression of atherosclerosis in patients with rheumatoid arthritis is partially reflected by disease severity at the time of diagnosis: 11-year prospective follow-up. Scandinavian Journal of Rheumatology, 47, 20-21
Open this publication in new window or tab >>Increased progression of atherosclerosis in patients with rheumatoid arthritis is partially reflected by disease severity at the time of diagnosis: 11-year prospective follow-up
2018 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 47, p. 20-21Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-151574 (URN)000442295400032 ()
Note

Supplement: 129

Meeting Abstract: PP15

Available from: 2018-09-07 Created: 2018-09-07 Last updated: 2018-09-07Bibliographically approved
Wahlin, B., Fasth, A. E., Karp, K., Lejon, K., Södergren, A. & Wållberg-Jonsson, S. (2017). Cd8+cd28- t-lymphocytes are associated with subclinical atherosclerosis in patients with rheumatoid arthritis. Paper presented at Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN. Annals of the Rheumatic Diseases, 76, 250-250
Open this publication in new window or tab >>Cd8+cd28- t-lymphocytes are associated with subclinical atherosclerosis in patients with rheumatoid arthritis
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2017 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, p. 250-250Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2017
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-142290 (URN)10.1136/annrheumdis-2017-eular.4364 (DOI)000413181400665 ()
Conference
Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2018-06-09Bibliographically approved
Agca, R., Heslinga, S. C., Rollefstad, S., Heslinga, M., McInnes, B., Peters, M. J., . . . Nurmohamed, M. T. (2017). EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Annals of the Rheumatic Diseases, 76(1), 17-28
Open this publication in new window or tab >>EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update
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2017 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, no 1, p. 17-28Article, review/survey (Refereed) Published
Abstract [en]

Patients with rheumatoid arthritis (RA) and other inflammatory joint disorders (IJD) have increased cardiovascular disease (CVD) risk compared with the general population. In 2009, the European League Against Rheumatism (EULAR) taskforce recommended screening, identification of CVD risk factors and CVD risk management largely based on expert opinion. In view of substantial new evidence, an update was conducted with the aim of producing CVD risk management recommendations for patients with IJD that now incorporates an increasing evidence base. A multidisciplinary steering committee (representing 13 European countries) comprised 26 members including patient representatives, rheumatologists, cardiologists, internists, epidemiologists, a health professional and fellows. Systematic literature searches were performed and evidence was categorised according to standard guidelines. The evidence was discussed and summarised by the experts in the course of a consensus finding and voting process. Three overarching principles were defined. First, there is a higher risk for CVD in patients with RA, and this may also apply to ankylosing spondylitis and psoriatic arthritis. Second, the rheumatologist is responsible for CVD risk management in patients with IJD. Third, the use of non-steroidal anti-inflammatory drugs and corticosteroids should be in accordance with treatment-specific recommendations from EULAR and Assessment of Spondyloarthritis International Society. Ten recommendations were defined, of which one is new and six were changed compared with the 2009 recommendations. Each designated an appropriate evidence support level. The present update extends on the evidence that CVD risk in the whole spectrum of IJD is increased. This underscores the need for CVD risk management in these patients. These recommendations are defined to provide assistance in CVD risk management in IJD, based on expert opinion and scientific evidence.

National Category
General Practice Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-131644 (URN)10.1136/annrheumdis-2016-209775 (DOI)000392425200005 ()27697765 (PubMedID)
Available from: 2017-02-28 Created: 2017-02-28 Last updated: 2019-05-23Bibliographically approved
Makoveichuk, E., Ruge, T., Nilsson, S., Södergren, A. & Olivecrona, G. (2017). High concentrations of Angiopoietin-like Protein 4 detected in serum from patients with rheumatoid arthritis can be explained by non-specific antibody reactivity. PLoS ONE, 12(1), Article ID e0168922.
Open this publication in new window or tab >>High concentrations of Angiopoietin-like Protein 4 detected in serum from patients with rheumatoid arthritis can be explained by non-specific antibody reactivity
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2017 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 1, article id e0168922Article in journal (Refereed) Published
Abstract [en]

Angiopoietin-like protein 4 (ANGPTL4) is suggested to be a master regulator of plasma triglyceride metabolism. Our aim was to study whether the previously reported high levels of ANGPTL4 detected in serum from patients with rheumatoid arthritis (RA) by ELISA was due to any specific molecular form of this protein (oligomers, monomers or fragments). ANGPTL4 levels were first determined in serum from 68 RA patients and 43 age and sex matched control subjects and the mean values differed by a factor of 5.0. Then, ANGPTL4 was analyzed after size exclusion chromatography (SEC) of serum samples. With serum from one of the RA patients with high levels of ANGPTL4, the dominant reactivity was found in fractions corresponding to high-molecular weight proteins. In addition, a minor peak of reactivity eluting late from the column was found both in the patient and in controls. By the use of Hetero-Block r, and by careful selection of antibodies, we documented non-specific reactions for ANGPTL4 in 39% of samples from the RA patients, most likely due to cross-reactivity of the antibodies with rheumatoid factor (RF). The corresponding figure for control subjects was 6.3%. After corrections for non-specific reactions, the mean level of ANGPTL4 in serum from RA patients was still significantly higher than in control individuals (mean levels were 101 +/- 62 and 67 +/- 39 ng/ml respectively, P = 0.02). We re-analyzed samples from our previously published studies on ANGPL4 levels in patients on hemodialysis and patients with diabetes type 2. These samples did not show false positive reactions. The levels of ANGPTL4 were comparable to those detected previously.

National Category
Rheumatology and Autoimmunity Chemical Sciences
Identifiers
urn:nbn:se:umu:diva-131869 (URN)10.1371/journal.pone.0168922 (DOI)000392405300017 ()28107351 (PubMedID)
Available from: 2017-02-27 Created: 2017-02-27 Last updated: 2019-05-23Bibliographically approved
Innala, L., Sjöberg, C., Möller, B., Ljung, L., Smedby, T., Södergren, A., . . . Wållberg-Jonsson, S. (2016). Co-morbidity in patients with early rheumatoid arthritis - inflammation matters. Arthritis Research & Therapy, 18, Article ID 33.
Open this publication in new window or tab >>Co-morbidity in patients with early rheumatoid arthritis - inflammation matters
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2016 (English)In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 18, article id 33Article in journal (Refereed) Published
Abstract [en]

Background: Patients with rheumatoid arthritis (RA) suffer from co-morbidities that contribute to a shortened lifespan. Inflammation is important for the development of cardiovascular disease, but little is known on its relationship with other co-morbidities. We investigated the role of inflammation for the development of new comorbidities in early RA. Methods: Since 1995, all patients with early RA in Northern Sweden are included in a prospective study on comorbidities, with a total of 950 patients being included. At the time for this study, 726 had been ill for >= 5 years. Data on co-morbidities, clinical and laboratory disease activity and pharmacological therapy were collected from patient records and further validated using a questionnaire at RA onset (T0) and after 5 years (T5). Results: Of the patients, 53.2 % of the patients had one or more co-morbidity at onset, the commonest being: hypertension (27.3 %), obstructive pulmonary disease (13.9 %), diabetes (8.0 %), hypothyroidism (6.3 %) and malignancy (5.0 %). After 5 years, 41.0 % had developed at least one new co-morbidity, the most common being: hypertension (15.1 %), malignancy (7.6 %), stroke/transient ischemic accident (5.1 %), myocardial infarction (4.3 %) and osteoporosis (3.7 %). Age at disease onset, a raised erythrocyte sedimentation rate (ESR) at inclusion, previous treatment with glucocorticoids (GC; p < 0.001 for all), extra-articular RA (Ex-RA; p < 0.01), DAS28 (area under the curve) at 24 months (p < 0.05), previous smoking at inclusion (p = 0.058) and male gender (p < 0.01) were associated with a new co-morbidity overall at T5. Treatment with biologics (p < 0.05) reduced the risk. In multiple logistic regression modelling, ESR (p = 0.036) at inclusion was associated with a new co-morbidity after 5 years, adjusted for age, sex, smoking and GC treatment. In a similar model, Ex-RA (p < 0.05) was associated with a new co-morbidity at T5. In a third model, adjusted for age and sex, a new pulmonary co-morbidity was associated with a smoking history at inclusion (p < 0.01), but not with ESR. Conclusion: There was substantial co-morbidity among early RA patients already at disease onset, with considerable new co-morbidity being added during the first five years. Measures of disease activity were associated with the occurrence of a new co-morbidity indicating that the inflammation is of importance in this context.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Early rheumatoid arthritis, Co-morbidity, Inflammation
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-117189 (URN)10.1186/s13075-016-0928-y (DOI)000368655100001 ()
Available from: 2016-02-24 Created: 2016-02-23 Last updated: 2018-06-07Bibliographically approved
Södergren, A., Karp, K., Bengtsson, C., Möller, B., Rantapää-Dahlqvist, S. & Wållberg-Jonsson, S. (2015). Is Lipoprotein-Associated Phospholipase A2a Link between Inflammation and Subclinical Atherosclerosis inRheumatoid Arthritis?. BioMed Research International, Article ID 673018.
Open this publication in new window or tab >>Is Lipoprotein-Associated Phospholipase A2a Link between Inflammation and Subclinical Atherosclerosis inRheumatoid Arthritis?
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2015 (English)In: BioMed Research International, ISSN 2314-6133, E-ISSN 2314-6141, article id 673018Article in journal (Refereed) Published
Abstract [en]

Objective. Lipoprotein-associated phospholipase A2 (Lp-PLA2), a marker of vascular inflammation, is associated with cardiovascular disease. This prospective study of an inception cohort aimed to investigate whether the level of Lp-PLA2 is associated with subclinical atherosclerosis in patients with rheumatoid arthritis (RA). Methods. Patients from northern Sweden diagnosed with early RA were consecutively recruited into an ongoing prospective study. From these, all patients <= 60 years (n = 71) were included for measurements of subclinical atherosclerosis at inclusion (T0) and five years later (T5). Forty age-and sex-matched controls were included. The patients were clinically assessed, SCORE, Reynolds Risk Score, and Larsen score were calculated, and blood samples were drawn from all individuals at T0 and T5. Results. There was no significant difference in the level of Lp-PLA2 between patients with RA and controls (p > 0.05). In simple linear regression models among patients with RA, Lp-PLA2 at T0 was significantly associated with intima media thickness (IMT) at T0 and T5, flow mediated dilation (FMD) at T0 and T5, ever smoking, male sex, HDL-cholesterol (inversely), non-HDL-cholesterol, SCORE, Reynolds Risk Score, and Larsen score (p < 0.05). Conclusion. In this cohort of patients with early RA, the concentration of Lp-PLA2 was associated with both subclinical atherosclerosis and disease severity.

Place, publisher, year, edition, pages
Hindawi Publishing Corporation, 2015
Keywords
phospholipase, cardiovascular disease, Lp-PLA2
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-111521 (URN)10.1155/2015/673018 (DOI)000363154200001 ()26504820 (PubMedID)
Available from: 2015-12-03 Created: 2015-11-13 Last updated: 2018-06-07Bibliographically approved
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