Abstract

ContextRheumatoid arthritis (RA) is an autoimmune, symmetrical polyarticular disease characterized by chronic inflammation of the synovial joints. Microalbuminuria (MA) occurs as leakage of small amounts of albumin into the urine. Metabolic syndrome (MetS) describes the risk factors for cardiovascular diseases such as dyslipidemia, obesity, hypertension, and diabetes.AimThe aim of this study was to detect the prevalence of MA in patients with RA and study its correlation with disease activity and severity. Our aim extends to identify the association of MA with MetS in RA.Patients and methodsThis study was carried out on 30 adult RA patients, 30% of them were men and 70% were women (mean±SD: 42.27±10.99 years). Their mean disease duration was 12.8±7.06 years. A total of 20 apparently healthy adults, age-matched and sex-matched served as a control group. All the patients were subjected to full history taking, full clinical examination, laboratory investigations, and assessment of disease activity using the disease activity score for 28joints score. Urinary microalbumin level was measured in all participants in early morning samples by the immunoturbidometry method. MetS was assessed in all participants according to Grundy’s criteria.ResultsThe frequency of MetS was highly statistically significant in patients with RA compared with the control group. The RA patients’ group had highly significantly elevated mean values of urinary microalbumin and urinary albumin to creatinine ratio compared with the control group.ConclusionMA and MetS are frequent in RA, particularly in those with long-standing disease. Early detection of albuminuria allows early intervention with the goal of reducing inflammation development in RA, cardiovascular risk. MetS is frequent in RA patients with MA.

Highlights

  • Rheumatoid arthritis (RA) is an autoimmune, symmetrical polyarticular disease which is characterized by chronic inflammation of the synovial joints affecting primarily the diarthroidal joints

  • MA is not a small albumin molecule found in the urine, but it is defined as 30–299 mg of albumin being lost in urine per day undetectable by the dipstick method

  • Less MTX uses were independent predictors associated with the presence of Metabolic syndrome (MetS) in women with early RA. These findings suggest that physicians should screen for MetS in women with early RA to control its components and reduce their risk of CV diseases

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Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune, symmetrical polyarticular disease which is characterized by chronic inflammation of the synovial joints affecting primarily the diarthroidal joints. The pathogenic characteristic features of RA includes synovial hyperplasia and inflammation accompanied by cartilage loss and joint destruction, which result in extremely painful, impaired functional status that produces substantial morbidity as well as an increase in mortality [1]. Microalbuminuria (MA) occurs as a leakage of small amounts of albumin into the urine, when there is an abnormal high permeability for albumin in the renal glomerulus of the kidney. MA is not a small albumin molecule found in the urine, but it is defined as 30–299 mg of albumin being lost in urine per day undetectable by the dipstick method. The level of protein in urine is more than or equal to 300 mg a day [2]

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