Results The literature review and meta- analysis identified decreased PA and increased time spent in SB in these population s , which may exacerbate both their lower physical fitness and the symptoms of their health disorders .
Background Physical activity ( PA ) is essential for children throughout their growth and maturation .
It improves physiological and psychological health and limits the risk of developing metabolic disorders .
However , some chronic physiological and metabolic diseases may lead to decreased PA .
The diversity of outcomes in the literature offers no consensus for physical activity and sedentary levels in children with juvenile idiopathic arthritis ( JIA ) or inflammatory bowel disease ( IBD ) .
The aim was to examine  PA and SB  in children with JIA or IBD compared to their healthy peers .
Anti-tumor necrosis factor therapy improves insulin resistance, beta cell function and insulin signaling in active rheumatoid arthritis patients with high insulin resistance
Introduction Prevalence of insulin resistance and the metabolic syndrome has been reported to be high in rheumatoid arthritis ( RA ) patients .  Tumor necrosis factor ( TNF ) , a pro-inflammatory cytokine with a major pathogenetic role in RA , may promote insulin resistance by inducing Ser312 phosphorylation ( p-Ser312 ) of insulin receptor substrate (IRS)-1 and downregulating phosphorylated (p-)AKT . We examined whether anti-TNF therapy improves insulin resistance in RA patients and assessed changes in the insulin signaling cascade . Methods Prospect i ve study of RA patients receiving anti-TNF agents ( infliximab , n = 49 , adalimumab , n = 11 , or etanercept , n = 1 ) due to high disease activity score in 28 joints ( DAS28 > 5.1 ) . A complete biochemical profile was obtained at weeks 0 and 12 of treatment . Insulin resistance , insulin sensitivity and pancreatic beta cell function were measured by the Homeostasis Model Assessment ( HOMA-IR ) , the Quantitative Insulin Sensitivity Check Index ( QUICKI ) and the HOMA-B respectively . Protein extracts from peripheral blood mononuclear cells were assayed by western blot for p-Ser312 IRS-1 and p-AKT . RA patients treated with abatacept ( CTLA4.Ig ) were used as a control group for insulin signaling studies . Results At study entry , RA patients with high insulin resistance ( HOMA-IR above median ) had significantly higher mean DAS28 ( P = 0.011 ) , serum triglycerides ( P = 0.015 ) , and systolic blood pressure levels ( P = 0.024 ) than patients with low insulin resistance . After 12 weeks of anti-TNF therapy , patients with high insulin resistance demonstrated significant reduction in HOMA-IR ( P < 0.001 ) , HOMA-B ( P = 0.001 ) , serum triglycerides ( P = 0.039 ) , and increase in QUICKI ( P < 0.001 ) and serum HDL-C ( P = 0.022 ) . Western blot analysis in seven active RA patients with high insulin resistance showed reduction in p-Ser312 IRS-1 ( P = 0.043 ) and increase in p-AKT ( P = 0.001 ) over the study period . In contrast , the effect of CTLA4.Ig on p-Ser312 IRS-1 and p-AKT levels was variable . Conclusions Anti-TNF therapy improved insulin sensitivity and reversed defects in the insulin signaling cascade in RA patients with active disease and high insulin resistance . The impact of these biochemical changes in modifying cardiovascular disease burden in active RA patients remains to be seen
Results The literature review and meta- analysis identified decreased PA and increased time spent in SB in these population s , which may exacerbate both their lower physical fitness and the symptoms of their health disorders .
Background Physical activity ( PA ) is essential for children throughout their growth and maturation .
It improves physiological and psychological health and limits the risk of developing metabolic disorders .
However , some chronic physiological and metabolic diseases may lead to decreased PA .
The diversity of outcomes in the literature offers no consensus for physical activity and sedentary levels in children with juvenile idiopathic arthritis ( JIA ) or inflammatory bowel disease ( IBD ) .
The aim was to examine  PA and SB  in children with JIA or IBD compared to their healthy peers .