The primary objective of this Mentored Patient-Oriented Career Development Award is to develop the skills and experience required to become a successful independent clinical investigator. In order to attain this objective, a training program has been constructed to foster: 1. Advanced training in the methods of epidemiology, biostatistics, and clinical trial design 2. A superior research environment made up of senior clinical investigators and well recognized experts in fields related to the scientific proposal 3. The groundwork on which to build future research projects and collaborations The scientific objective of this proposal is to explore the determinants of altered body composition in rheumatoid arthritis (RA). In RA, lean body mass is 10-15% lower than in non-RA controls despite the preservation of body weight. This observation suggests a net gain in fat mass. This has not been confirmed, however, and no studies have examined regional patterns of fat and muscle distribution in RA. In particular, patterns of fat deposition, particularly fat localized to the abdominal cavity (visceral fat) has emerged as a potent predictor of metabolic syndrome and cardiovascular disease. Further, an increase in fat mass combined with a net loss in lean body mass, termed sarcopenic obesity, has been associated with metabolic syndrome, cardiovascular disease, and mortality in non-RA populations.
The specific aims of this proposal are to: 1. Characterize body composition and identify the prevalence of sarcopenic, obesity, and sarcopenic obesity in patients with RA compared to matched non-RA controls 2. Characterize serum adipokine profiles, insulin resistance, and the prevalence of components of the metabolic syndrome in patients with RA compared to matched non-RA controls. 3. Identify the inflammatory and non-inflammatory factors associated with altered body composition phenotypes, adipokine profiles, and insulin resistance in patients with RA . ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23AR054112-02
Application #
7279286
Study Section
Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
Program Officer
Witter, James
Project Start
2006-09-01
Project End
2011-08-31
Budget Start
2007-09-01
Budget End
2008-08-31
Support Year
2
Fiscal Year
2007
Total Cost
$133,930
Indirect Cost
Name
Johns Hopkins University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Sammut, Amanda; Shea, Steven; Blumenthal, Roger S et al. (2017) Albuminuria in Rheumatoid Arthritis: Associations With Rheumatoid Arthritis Characteristics and Subclinical Atherosclerosis. Arthritis Care Res (Hoboken) 69:1799-1808
Lusa, Amanda L; Amigues, Isabelle; Kramer, Henry R et al. (2015) Indicators of walking speed in rheumatoid arthritis: relative influence of articular, psychosocial, and body composition characteristics. Arthritis Care Res (Hoboken) 67:21-31
Giles, Jon T; Danielides, Stamatina; Szklo, Moyses et al. (2015) Insulin resistance in rheumatoid arthritis: disease-related indicators and associations with the presence and progression of subclinical atherosclerosis. Arthritis Rheumatol 67:626-36
Chung, Cecilia P; Giles, Jon T; Kronmal, Richard A et al. (2013) Progression of coronary artery atherosclerosis in rheumatoid arthritis: comparison with participants from the Multi-Ethnic Study of Atherosclerosis. Arthritis Res Ther 15:R134
Haque, Uzma J; Bathon, Joan M; Giles, Jon T (2012) Association of vitamin D with cardiometabolic risk factors in rheumatoid arthritis. Arthritis Care Res (Hoboken) 64:1497-504
Kramer, Henry R; Fontaine, Kevin R; Bathon, Joan M et al. (2012) Muscle density in rheumatoid arthritis: associations with disease features and functional outcomes. Arthritis Rheum 64:2438-50
Darrah, Erika; Rosen, Antony; Giles, Jon T et al. (2012) Peptidylarginine deiminase 2, 3 and 4 have distinct specificities against cellular substrates: novel insights into autoantigen selection in rheumatoid arthritis. Ann Rheum Dis 71:92-8
Knowlton, N; Wages, J A; Centola, M B et al. (2012) Apolipoprotein B-containing lipoprotein subclasses as risk factors for cardiovascular disease in patients with rheumatoid arthritis. Arthritis Care Res (Hoboken) 64:993-1000
Giles, Jon T; Post, Wendy S; Blumenthal, Roger S et al. (2011) Longitudinal predictors of progression of carotid atherosclerosis in rheumatoid arthritis. Arthritis Rheum 63:3216-25
Giles, Jon T; van der Heijde, Desiree M; Bathon, Joan M (2011) Association of circulating adiponectin levels with progression of radiographic joint destruction in rheumatoid arthritis. Ann Rheum Dis 70:1562-8

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