Article

Metabolic syndrome prevalence is increased in rheumatoid arthritis patients and is associated with disease activity.

Division of Rheumatology, Clinical Hospital of Porto Alegre and Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul , Brazil.
Scandinavian journal of rheumatology (impact factor: 2.51). 03/2012; 41(3):186-91. DOI:10.3109/03009742.2011.626443 pp.186-91
Source: PubMed

ABSTRACT To evaluate the prevalence of metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) vs. controls, and to verify possible associations of MetS with specific disease-related factors.
The subjects were 283 RA patients and 226 healthy controls, frequency matched by age and sex. MetS was defined according to National Cholesterol Education Program (NCEP) criteria. Disease activity was evaluated with the Disease Activity Score using 28 joints (DAS28). A standardized clinical evaluation was performed and cardiovascular risk factors were assessed.
The criteria for MetS were met by 39.2% RA patients vs. 19.5% in the control group (p < 0.001). Increased waist circumference, elevated blood pressure (BP), and fasting glucose were more frequent in RA patients than controls (p < 0.001 for all associations). By multiple logistic regression analysis (adjusted for age, sex, and years at school), the risk of having MetS was significantly higher for RA patients than for controls [odds ratio (OR) 1.87, 95% confidence interval (CI) 1.17-3.00, p = 0.009]. The DAS28 was significantly higher in RA patients with MetS than in those without MetS (3.59 ± 1.27 vs. 3.14 ± 1.53; p = 0.01). Disease duration, the presence of rheumatoid factor, and extra-articular manifestations were similar for patients with and without MetS.
MetS frequency was higher in RA patients than in controls. Among RA patients, MetS was associated with disease activity. The higher prevalence of cardiovascular risk factors in RA suggests that inflammatory processes play a notable role in the development of cardiovascular disease (CVD), and indicates that tight control of systemic inflammatory activity and CVD modifiable risk factors should be recommended.

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    Dataset: Novel Risk Factors in CVD in RA
    Jenny Amaya-Amaya, Juan Camilo Sarmiento-Monroy, Ruben-Dario Mantilla, Ricardo Pineda-Tamayo, Adriana Rojas-Villarraga, Juan-Manuel Anaya
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    ABSTRACT: Since cardiovascular disease (CVD) is the most common cause of mortality in patients with rheumatoid arthritis (RA), we aimed to determine factors associated with such a complication in a large series of Colombian patients. This was a cross-sectional analytical study in which 800 consecutive Colombian patients with RA were assessed for variables associated with CVD. Furthermore, a systematic literature review was performed to address the state of the art about non-traditional risk factors for CVD in RA. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed in data extraction, analysis, and reporting of articles selected. Hypercholesterolemia, type 2 diabetes mellitus, abnormal body mass index, abdominal obesity, and current smoking were all traditional risk factors significantly associated with CVD in Colombians. As non-traditional risk factors, familial autoimmunity, more than 10 years of duration of the disease, patients working on household duties, use of systemic steroids, and low education level were associated with CVD in the studied population. Out of a total of 9,812 articles identified in PubMed and Scopus databases, 140 fulfilled the eligibility criteria and were included. Through this systematic review, several factors and outcomes related to CVD were confirmed and identified. These were categorized into genetics, RA-related, and others. Traditional risk factors do not completely explain the high rates of CVD in patients with RA; thus, novel risk factors related to autoimmunity are now recognized predicting the presence of CVD as strong as traditional risk factors. Our results may assist health professionals and policymakers in making decisions about CVD in patients with RA.
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Keywords

226 healthy controls
 
28 joints
 
95% confidence interval
 
blood pressure
 
cardiovascular disease
 
cardiovascular risk factors
 
control group
 
controls [odds ratio
 
CVD modifiable risk factors
 
Disease activity
 
Disease Activity Score
 
multiple logistic regression analysis
 
National Cholesterol Education Program
 
notable role
 
RA patients
 
rheumatoid arthritis
 
rheumatoid factor
 
specific disease-related factors
 
systemic inflammatory activity
 
verify possible associations
 

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