Prevalence of Metabolic Syndrome in Patients with Rheumatoid Arthritis

Abstract

It was stated that the control group enrolled in the study contained subjects who did not have inflammatory bowel disease. This is a poor description that fails to reflect the characteristics of the control group and doesn’t clarify whether this population has other diseases or not. The authors have reported the prevalence of metabolic syndrome to be 16% in the control group with an average age of 49.8 years and gender distribution of 85.1% women. However, these findings do not match the data obtained from two large-scale epidemiological studies conducted in our country. The prevalence of metabolic syndrome among adult patients has been reported in two studies and the results are 37.1% in the TEKHARF study (Turkish Adult Risk Factor Survey) (in male patients 31.2%, in female patients 42.8%)[2] and 33.9% in the METSAR study (Metabolic Syndrome Prevalence Survey in Turkey) (in male patients 28%, in female patients 39.6%). The prevalence of metabolic syndrome is known to increase with age and to be higher in women.[3] Consequently, it is obvious that the evaluation of the study should be radically changed to reflect that the prevalence of metabolic syndrome in patients with rheumatoid arthritis is much lower than that of the overall population! In the article, a correlation was reported between the use of corticosteroids and fasting blood glucose level, but it wasn’t clarified whether or not there was a difference between corticosteroid use and triglycerides. Increased blood glucose is among the metabolic effects of corticosteroids while the most important dyslipidemic effect of corticosteroids is the heightened level of triglycerides.[4,5] It is possible to attribute the increased level of triglycerides to steroids used by 54.9% of the patients. Therefore, we believe that comparing a group of patients using corticosteroids to healthy individuals who do not use corticosteroids and attributing the findings like high levels of triglyceride and blood pressure (which are well-known side effects of steroids) to the disease or the degree of activity of the disease can be misleading.