Karvounaris S A, Sidiropoulos P I, Papadakis J A, Spanakis E K, Bertsias G K, Kritikos H D, Ganotakis E S, Boumpas D T
Division of Rheumatology, Clinical Immunology and Allergy, University of Crete, Medical School, Voutes 71500, Heraklion, Greece.
Ann Rheum Dis. 2007 Jan;66(1):28-33. doi: 10.1136/ard.2006.053488. Epub 2006 Jun 22.
Patients with rheumatoid arthritis have an increased risk for cardiovascular disease (CVD). The prevalence of metabolic syndrome (MetS)-a major contributor to CVD-in a cohort of patients with rheumatoid arthritis and its relationship with rheumatoid arthritis related factors is investigated here.
200 outpatients with rheumatoid arthritis (147 women and 53 men), with a mean (standard deviation (SD)) age of 63 (11) years, and 400 age and sex-matched controls were studied. MetS was assessed according to the adult treatment panel III criteria and rheumatoid arthritis disease activity by the disease activity score of 28 joints (DAS28). A standard clinical evaluation was carried out, and a health and lifestyle questionnaire was completed.
The overall prevalence of MetS was 44% in patients with rheumatoid arthritis and 41% in controls (p = 0.5). Patients with rheumatoid arthritis were more likely to have low high-density lipoprotein cholesterol compared with controls (p = 0.02), whereas controls were more likely to have increased waist circumference or raised blood pressure (p = 0.001 and 0.003, respectively). In multivariate logistic regression analysis adjusting for demographics and rheumatoid arthritis treatment modalities, the risk of having moderate-to-high disease activity (DAS28>3.2) was significantly higher in patients with MetS compared with those with no MetS components (OR 9.24, 95% CI 1.49 to 57.2, p = 0.016).
A high, albeit comparable to the control population, prevalence of MetS was found in middle-to-older aged patients with rheumatoid arthritis. The correlation of rheumatoid arthritis disease activity with MetS suggests that the increased prevalence of coronary heart disease in patients with rheumatoid arthritis may, at least in part, be attributed to the inflammatory burden of the disease.
类风湿关节炎患者患心血管疾病（CVD）的风险增加。本文研究了类风湿关节炎患者队列中代谢综合征（MetS）（CVD的主要促成因素）的患病率及其与类风湿关节炎相关因素的关系。
研究了200例类风湿关节炎门诊患者（147名女性和53名男性），平均（标准差）年龄为63（11）岁，以及400名年龄和性别匹配的对照者。根据成人治疗小组III标准评估MetS，并通过28个关节疾病活动评分（DAS28）评估类风湿关节炎疾病活动度。进行了标准的临床评估，并完成了健康和生活方式问卷。
类风湿关节炎患者中MetS的总体患病率为44%，对照组为41%（p = 0.5）。与对照组相比，类风湿关节炎患者更易出现高密度脂蛋白胆固醇水平低的情况（p = 0.02），而对照组更易出现腰围增加或血压升高的情况（分别为p = 0.001和0.003）。在对人口统计学和类风湿关节炎治疗方式进行调整的多因素逻辑回归分析中，与无MetS成分的患者相比，患有中至高度疾病活动（DAS28>3.2）的MetS患者风险显著更高（比值比9.24，95%置信区间1.49至57.2，p = 0.016）。
在中老年类风湿关节炎患者中发现了较高的MetS患病率，尽管与对照人群相当。类风湿关节炎疾病活动度与MetS的相关性表明，类风湿关节炎患者冠心病患病率增加可能至少部分归因于该疾病的炎症负担。
