Abstract Objectives Excess visceral adipose tissue (VAT) mass increases cardiovascular disease (CVD) risk. Exercise supports overall health and VAT mass reduction in rheumatoid arthritis (RA) – which is a high-risk population for CVD. Unlike tumour necrosis factor (TNF), interleukin-6 (IL-6) is upregulated following exercise and may mediate the reduction in VAT mass. Since treatment strategies for patients with RA include the inhibition of IL-6 (IL-6i) or TNF (TNFi), the hypothesis of this study was that in patients with RA treatment with IL-6i abolishes the cardioprotective effects of exercise on VAT reduction compared to patients with TNFi treatment. Methods In this secondary analysis of a randomized controlled trial, 69 patients with RA in stable TNFi (n=40) or IL-6i (n=29) therapy were stratified for treatment and assigned to a 12-week supervised high intensity interval training (HIIT) intervention or no exercise (control). The primary objective was to investigate the effects of TNFi or IL-6i therapy on exercise-induced changes in VAT mass (g) from baseline to 12-week follow-up, assessed by abdominal magnetic resonance imaging. Results Compared to control, HIIT did not change VAT mass in either TNFi (-34 g 95% CI, -208 to 140 g; p=0.69) or IL-6i (-9 g 95% CI, -228 to 211 g; p=0.93) treatment groups. There was no interaction between IL-6i and exercise on changes in VAT mass (25 g 95% CI, -255 to 306 Pinteraction= 0.85). Exercise-induced changes to the subcutaneous adipose tissue and insulin sensitivity were negligible and not significantly different between treatment modalities. Conclusions A 12-week HIIT intervention did not reduce VAT mass in patients with RA at high risk of CVD in treatment with either TNFi or IL-6i.Change in VAT mass (g)
Christensen et al. (Sat,) studied this question.