Metabolic syndrome is common among middle-to-older aged Mediterranean patients with rheumatoid arthritis and correlates with disease activity: a retrospective, cross-sectional, controlled, study

• Published in: Annals of the rheumatic diseases 2007-01, Vol.66 (1), p.28-33
• Main Authors: Karvounaris, S A, Sidiropoulos, P I, Papadakis, J A, Spanakis, E K, Bertsias, G K, Kritikos, H D, Ganotakis, E S, Boumpas, D T
• Format: Article
• Language: English
• Subjects: Adult Treatment Panel III of the National Cholesterol Education Program; Aged; Angina pectoris; Arthritis, Rheumatoid - complications; Arthritis, Rheumatoid - epidemiology; Arthritis, Rheumatoid - immunology; Automation; Biological and medical sciences; Blood pressure; BMI; body mass index; Cardiovascular disease; Case-Control Studies; CHD; Chi-Square Distribution; Cholesterol; coronary heart disease; Cross-Sectional Studies; CVD; Cytokines; DAS28; disease activity score of 28 joints; Diseases of the osteoarticular system; EGIR; erythrocyte sedimentation rate; ESR; European Group for the Study of Insulin Resistance; Extended Report; Fasting; Female; Greece - epidemiology; HDL-C; Health Status Indicators; high-density lipoprotein cholesterol; high-sensitivity C reactive protein; Hospitals; hs-CRP; Humans; Hypertension; Inflammation; Inflammatory joint diseases; Insulin; Insulin resistance; Joints - pathology; Kinases; LDL-C; Logistic Models; low-density lipoprotein cholesterol; Male; Medical sciences; Mens health; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Metabolic Syndrome - immunology; Methods; MetS; Middle Aged; Miscellaneous; Morbidity; Mortality; NCEP ATPIII; Other metabolic disorders; Patients; Population; Prevalence; Retrospective Studies; Rheumatoid arthritis; Rheumatology; Risk; Studies; TNF; Triglycerides; Tumor necrosis factor-TNF; tumour necrosis factor; WHO; World Health Organization
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2006.053488

Objectives: Patients with rheumatoid arthritis have an increased risk for cardiovascular disease (CVD). The prevalence of metabolic syndrome (MetS)—a major contributor to CVD—in a cohort of patients with rheumatoid arthritis and its relationship with rheumatoid arthritis related factors is investigated here. Methods: 200 outpatients with rheumatoid arthritis (147 women and 53 men), with a mean (standard deviation (SD)) age of 63 (11) years, and 400 age and sex-matched controls were studied. MetS was assessed according to the adult treatment panel III criteria and rheumatoid arthritis disease activity by the disease activity score of 28 joints (DAS28). A standard clinical evaluation was carried out, and a health and lifestyle questionnaire was completed. Results: The overall prevalence of MetS was 44% in patients with rheumatoid arthritis and 41% in controls (p = 0.5). Patients with rheumatoid arthritis were more likely to have low high-density lipoprotein cholesterol compared with controls (p = 0.02), whereas controls were more likely to have increased waist circumference or raised blood pressure (p = 0.001 and 0.003, respectively). In multivariate logistic regression analysis adjusting for demographics and rheumatoid arthritis treatment modalities, the risk of having moderate-to-high disease activity (DAS28>3.2) was significantly higher in patients with MetS compared with those with no MetS components (OR 9.24, 95% CI 1.49 to 57.2, p = 0.016). Conclusion: A high, albeit comparable to the control population, prevalence of MetS was found in middle-to-older aged patients with rheumatoid arthritis. The correlation of rheumatoid arthritis disease activity with MetS suggests that the increased prevalence of coronary heart disease in patients with rheumatoid arthritis may, at least in part, be attributed to the inflammatory burden of the disease.