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Prevalence, incidence and characteristics of the metabolic syndrome (MetS) in a cohort of Mexican Mestizo early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs: the complex relationship between MetS and disease activity.

Parra-Salcedo F, Contreras-Yáñez I, Elías-López D, Aguilar-Salinas CA, Pascual-Ramos V - Arthritis Res. Ther. (2015)

Bottom Line: Appropriated statistics and Cox regression analysis were used.Up to March 2014, data from 160 patients were analyzed.At baseline, they were more frequently middle-aged females and had moderate to high disease activity.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology and Immunology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, colonia sección XVI, Tlalpan 14000, México, DF, México. fepa_an@hotmail.com.

ABSTRACT

Introduction: A higher prevalence of metabolic syndrome (MetS) has been described in rheumatoid arthritis (RA), along with an association with disease activity. Objectives were to describe prevalence of MetS at RA diagnosis in a cohort of Mexican Mestizo early RA patients, and to define a causal association between MetS and disease activity.

Methods: The study population was a prospective cohort. At baseline and at fixed 6-months-intervals, patients had medical evaluations, fasting serum glucose, triglycerides, high-density lipoprotein cholesterol and acute reactant-phase determinations. MetS was defined according to international criteria and body mass index (BMI)≥30 kg/m2 was used as a surrogate of the waist circumference. The study was approved by the internal review board. Appropriated statistics and Cox regression analysis were used. All statistical tests were two-sided and evaluated at the 0.05 significance level.

Results: Up to March 2014, data from 160 patients were analyzed. At baseline, they were more frequently middle-aged females and had moderate to high disease activity. Prevalence of MetS varied from 11.3% to 17.5% in patients and was lower to that from matched controls (versus 26.3% to 30%, P≤0.01). Up to last follow-up, 39 patients (34.5%) developed incidental MetS. In the Cox regression analysis, cumulative disease activity score (DAS) 28 (odds ratio (OR): 1.81, 95% confidence interval (CI): 1.346 to 2.433, P=0.000) and baseline BMI (OR: 1.13, 96% CI: 1.035 to 1.236, P=0.007) were the only predictors for incidental MetS. RA patients with incidental MetS accumulated more disease activity and had less frequent remission than their counterparts. Logistic regression analysis showed that incidental MetS (OR: 0.2, 95% CI: 0.01 to 0.99, P=0.052) and baseline DAS28 (OR: 0.4, 95% CI: 0.2 to 0.9, P=0.02) were the only predictors for achieving or maintaining sustained (≥6 months) remission.

Conclusions: MetS prevalence in a cohort of early RA patients was lower than that from matched controls. Cumulative disease activity and higher BMI were risk factors for incidental Mets; higher baseline disease activity and incidental MetS prevented sustained remission. In addition to disease activity, MetS needs to be controlled to impact disease outcomes.

No MeSH data available.


Related in: MedlinePlus

Comparison of prevalence of metabolic syndrome between rheumatoid arthritis patients and matched controls. Numbers inside bars represent the number of patients and controls with metabolic syndrome according to the three different definitions. AHA/NHLBI, American Heart Association/National Heart, Lung and Blood Institute; IDF, International Diabetes Federation; NCEPT/ATPIII, National Cholesterol Education Program Adult Treatment Panel III; RA, rheumatoid arthritis.
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Fig1: Comparison of prevalence of metabolic syndrome between rheumatoid arthritis patients and matched controls. Numbers inside bars represent the number of patients and controls with metabolic syndrome according to the three different definitions. AHA/NHLBI, American Heart Association/National Heart, Lung and Blood Institute; IDF, International Diabetes Federation; NCEPT/ATPIII, National Cholesterol Education Program Adult Treatment Panel III; RA, rheumatoid arthritis.

Mentions: In RA patients, the prevalence of MetS varied from 11.3% (according to the International Diabetes Federation definition) to 17.5% (according to the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) definition). In healthy matched controls, prevalence of Mets was significantly higher and varied from 26.3% (according to the International Diabetes Federation definition) to 30% (according to the AHA/NHLBI definition), as shown in Figure 1 (P ≤0.01 for all comparisons).Figure 1


Prevalence, incidence and characteristics of the metabolic syndrome (MetS) in a cohort of Mexican Mestizo early rheumatoid arthritis patients treated with conventional disease modifying anti-rheumatic drugs: the complex relationship between MetS and disease activity.

Parra-Salcedo F, Contreras-Yáñez I, Elías-López D, Aguilar-Salinas CA, Pascual-Ramos V - Arthritis Res. Ther. (2015)

Comparison of prevalence of metabolic syndrome between rheumatoid arthritis patients and matched controls. Numbers inside bars represent the number of patients and controls with metabolic syndrome according to the three different definitions. AHA/NHLBI, American Heart Association/National Heart, Lung and Blood Institute; IDF, International Diabetes Federation; NCEPT/ATPIII, National Cholesterol Education Program Adult Treatment Panel III; RA, rheumatoid arthritis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4362822&req=5

Fig1: Comparison of prevalence of metabolic syndrome between rheumatoid arthritis patients and matched controls. Numbers inside bars represent the number of patients and controls with metabolic syndrome according to the three different definitions. AHA/NHLBI, American Heart Association/National Heart, Lung and Blood Institute; IDF, International Diabetes Federation; NCEPT/ATPIII, National Cholesterol Education Program Adult Treatment Panel III; RA, rheumatoid arthritis.
Mentions: In RA patients, the prevalence of MetS varied from 11.3% (according to the International Diabetes Federation definition) to 17.5% (according to the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) definition). In healthy matched controls, prevalence of Mets was significantly higher and varied from 26.3% (according to the International Diabetes Federation definition) to 30% (according to the AHA/NHLBI definition), as shown in Figure 1 (P ≤0.01 for all comparisons).Figure 1

Bottom Line: Appropriated statistics and Cox regression analysis were used.Up to March 2014, data from 160 patients were analyzed.At baseline, they were more frequently middle-aged females and had moderate to high disease activity.

View Article: PubMed Central - PubMed

Affiliation: Department of Rheumatology and Immunology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, colonia sección XVI, Tlalpan 14000, México, DF, México. fepa_an@hotmail.com.

ABSTRACT

Introduction: A higher prevalence of metabolic syndrome (MetS) has been described in rheumatoid arthritis (RA), along with an association with disease activity. Objectives were to describe prevalence of MetS at RA diagnosis in a cohort of Mexican Mestizo early RA patients, and to define a causal association between MetS and disease activity.

Methods: The study population was a prospective cohort. At baseline and at fixed 6-months-intervals, patients had medical evaluations, fasting serum glucose, triglycerides, high-density lipoprotein cholesterol and acute reactant-phase determinations. MetS was defined according to international criteria and body mass index (BMI)≥30 kg/m2 was used as a surrogate of the waist circumference. The study was approved by the internal review board. Appropriated statistics and Cox regression analysis were used. All statistical tests were two-sided and evaluated at the 0.05 significance level.

Results: Up to March 2014, data from 160 patients were analyzed. At baseline, they were more frequently middle-aged females and had moderate to high disease activity. Prevalence of MetS varied from 11.3% to 17.5% in patients and was lower to that from matched controls (versus 26.3% to 30%, P≤0.01). Up to last follow-up, 39 patients (34.5%) developed incidental MetS. In the Cox regression analysis, cumulative disease activity score (DAS) 28 (odds ratio (OR): 1.81, 95% confidence interval (CI): 1.346 to 2.433, P=0.000) and baseline BMI (OR: 1.13, 96% CI: 1.035 to 1.236, P=0.007) were the only predictors for incidental MetS. RA patients with incidental MetS accumulated more disease activity and had less frequent remission than their counterparts. Logistic regression analysis showed that incidental MetS (OR: 0.2, 95% CI: 0.01 to 0.99, P=0.052) and baseline DAS28 (OR: 0.4, 95% CI: 0.2 to 0.9, P=0.02) were the only predictors for achieving or maintaining sustained (≥6 months) remission.

Conclusions: MetS prevalence in a cohort of early RA patients was lower than that from matched controls. Cumulative disease activity and higher BMI were risk factors for incidental Mets; higher baseline disease activity and incidental MetS prevented sustained remission. In addition to disease activity, MetS needs to be controlled to impact disease outcomes.

No MeSH data available.


Related in: MedlinePlus