Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inflammatory arthritis
- 28 January 2011
- journal article
- clinical trial
- Published by Wiley in Arthritis Care & Research
- Vol. 63 (2), 195-202
- https://doi.org/10.1002/acr.20363
Abstract
Objective To evaluate the prevalence of the metabolic syndrome in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA). Methods Consecutive patients with RA, AS, or PsA who attended our outpatient arthritis clinics between July and November 2009 were recruited for a study of atherosclerotic risk factors and the metabolic syndrome, defined according to the 2009 joint statements using the Asian criteria for central obesity. Results Nine hundred thirty patients were studied (699 with RA, 122 with AS, and 109 with PsA; 70% women, mean ± SD age 51.1 ± 12.7 years). The mean ± SD disease duration for patients with RA, AS, and PsA was 5.3 ± 5.4, 6.0 ± 5.6, and 3.6 ± 3.1 years, respectively. The prevalence of metabolic syndrome was significantly higher in PsA (38%) than RA (20%) or AS (11%; P < 0.001). The odds ratios (ORs) for the metabolic syndrome compared to age‐ and sex‐matched controls were 0.98 (95% confidence interval [95% CI] 0.78–1.23, P = 0.88), 0.59 (95% CI 0.30–1.15, P = 0.12), and 2.68 (95% CI 1.60–4.50, P < 0.001), respectively, for RA, AS, and PsA. Patients with PsA had a significantly higher prevalence of impaired fasting glucose (30%; P < 0.001), low high‐density lipoprotein (HDL) cholesterol (33%; P < 0.001), high triglycerides level (21%; P = 0.008), central obesity (65%; P < 0.001), and high blood pressure (56%; P = 0.045). In a logistic regression model, the adjusted OR for the metabolic syndrome in PsA was 2.44 (95% CI 1.48–4.01, P < 0.001) relative to RA or AS. The adjusted ORs for central obesity, impaired fasting glucose, hypertriglyceridemia, and low HDL cholesterol were also significantly higher in PsA patients. Conclusion Patients with PsA, but not RA or AS, have a significantly higher prevalence of the metabolic syndrome compared to the general population. Among the 3 diseases studied, PsA has the highest prevalence of the metabolic syndrome and is associated with the highest cardiovascular risk.Keywords
This publication has 39 references indexed in Scilit:
- The High Prevalence of Subclinical Atherosclerosis in Patients With Ankylosing Spondylitis Without Clinically Evident Cardiovascular DiseaseMedicine, 2009
- Psoriasis and Atherothrombotic Diseases: Disease-Specific and Non–Disease-Specific Risk FactorsSeminars in Thrombosis and Hemostasis, 2009
- The risk of myocardial infarction and pharmacologic and nonpharmacologic myocardial infarction predictors in rheumatoid arthritis: A cohort and nested case–control analysisArthritis & Rheumatism, 2008
- High prevalence of subclinical atherosclerosis in psoriatic arthritis patients without clinically evident cardiovascular disease or classic atherosclerosis risk factorsArthritis Care & Research, 2007
- The pathogenesis of atherosclerosis in autoimmune rheumatic diseases: Roles of inflammation and dyslipidemiaJournal of Autoimmunity, 2007
- Relative contribution of cardiovascular risk factors and rheumatoid arthritis clinical manifestations to atherosclerosisArthritis & Rheumatism, 2005
- Diagnosis and Management of the Metabolic SyndromeCirculation, 2005
- The Metabolic Syndrome and 11-Year Risk of Incident Cardiovascular Disease in the Atherosclerosis Risk in Communities StudyDiabetes Care, 2005
- NCEP-Defined Metabolic Syndrome, Diabetes, and Prevalence of Coronary Heart Disease Among NHANES III Participants Age 50 Years and OlderDiabetes, 2003
- Cardiovascular Morbidity and Mortality Associated With the Metabolic SyndromeDiabetes Care, 2001