Investigation of the Association between Metabolic Syndrome and Disease Activity in Rheumatoid Arthritis

Maryam Sahebari,Zahra Rezaieyazdi,Amirhossein Sahebkar,Ladan Goshayeshi,Majid Ghayour-Mobarhan,Mohammad R Hatef,Zahra Mirfeizi,Saeed Akhlaghi,Gordon A Ferns

doi:10.1100/tsw.2011.111

Abstract

Rheumatoid arthritis (RA) is the most common form of autoimmune arthritis. Increased prevalence of metabolic syndrome (MetS) in RA may occur secondary to specific drug treatment and reduced physical activity associated with this condition. However, some recent studies suggest contradictory theories about the association of RA with MetS. This study was designed to evaluate the frequency of MetS in RA patients and the relationship between MetS with RA disease activity and body mass index (BMI). The study was conducted on 120 RA patients and 431 age- and sex-matched apparently healthy controls. A considerable proportion of patients were being treated with prednisolone and/or methotrexate and/or hydroxychloroquine. Disease activity was measured by the 28 joint count of disease activity score-Cerythrocyte sedimentation rate (DAS28ESR). MetS was evaluated according to International Diabetic Federation (IDF) and Adult Treatment Panel III (ATP III) criteria. The prevalence of MetS was significantly higher in the control group (p = 0.005). We did not find any difference in the prevalence of MetS between the patients with DAS < 3.2 and DAS ≥ 3.2. There was no association between the DAS28 score and the presence of MetS components by either definition. Multiple logistic regression analysis showed that the odds of a DAS > 3.2 in patients with BMI between 25 and 30 kg/m2 (OR = 0.1, p = 0.01) and BMI > 30 kg/m2 (OR = 0.3, p = 0.1), in comparison to BMI < 25 kg/m2, was 1/5 and 1/3, respectively. RA was not found to increase the risk of MetS. In addition, disease activity in RA patients was not influenced by the presence of MetS.

Highlights

Rheumatoid arthritis (RA) is an autoimmune disease associated with an increased risk of cardiovascular diseases (CVD) that accounts for about half of all deaths in this population[1]
The current study suggests that two definitions of metabolic syndrome (MetS), namely International Diabetic Federation (IDF) and Adult Treatment Panel III (ATP III) criteria, do not differ in their estimation of MetS prevalence in patients
We found no correlation between the RA disease activity index according to the DAS28ESR and MetS existence with both its definitions

Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease associated with an increased risk of cardiovascular diseases (CVD) that accounts for about half of all deaths in this population[1]. The frequency of MetS in RA patients is influenced by traditional factors such as race, age, and dietary customs, and by disease-specific factors[8,14]. To this end, we suggested an assessment of the frequency of MetS in a cohort of patients with RA, a comparison of the frequency of this syndrome with ATP III and IDF definitions, and an exploration of the possible relationship of MetS, its components, and body mass index (BMI) with disease activity in the Iranian population

Methods

Results

Conclusion