Metabolic syndrome in a cohort of rheumatoid arthritis patients

Abstract

Objectives. We aimed to assess the presence of MetS and traditional CV risk factors in a group of RA patients, compared to controls and their possible inter-relation with disease activity variables. Methods. We performed an observational study on 38 consecutive patients diagnosed with RA in Rheumatology Department of the Emergency County Hospital Craiova, based on ACR/EULAR criteria, in a one year interval between 2019-2020, and a control group including 30 subjects. Patients’ data were obtained from each subject according to the study protocol and included demographic, clinical, laboratory parameters. The presence of MetS was assessed according to the National Cholesterol Education Program Adult Treatment Panel (NCPATP) III. Results. Regarding the components of metabolic syndrome, as defined by NCPATP III, the differences established for the RA vs control groups were: increased waist circumference in 21 (52.25%) vs 13 (43.33%) subjects (p=0.002); high triglycerides (or under treatment) in 10 (26.31%) vs 6 (20%) subjects, p=0.004; low HDL cholesterol in 15 (39.47%) vs 7 (23.33%) subjects, p=0.002; high blood pressure (or under treatment) in 25 (65.79%) vs 12 (40%) subjects, p<0.0001; high blood glucose (or under treatment) in 7 (18.42%) vs 8 (26.66%) subjects, p= 0.08. Our data revealed a positive correlation between disease activity index and smoking (r=0.432, p=0.02), as well as between DAS 28-CRP and LDL cholesterol (r=0.454, p=0.004), or triglycerides (r=0.337, p=0.03). We also observed a strong, positive correlation between the presence of MetS and disease activity score (r=0.645, p<0.0001). Conclusions. Metabolic syndrome is associated with a high cardiovascular risk, the main cause of mortality in RA patients. Due to the chronic inflammatory state and the intervention of both traditional and non-traditional cardiovascular risk factors, each patient should undergo periodic evaluations, in order to apply an adequate and early therapeutic intervention and reduce further cardiovascular morbidity and mortality rates.