Tuen Mun Hospital, Chinese University of Hong Kong, Hong Kong, China.
Arthritis Care Res (Hoboken). 2011 Feb;63(2):195-202. doi: 10.1002/acr.20363.
To evaluate the prevalence of the metabolic syndrome in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA).
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.
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.
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.
评估代谢综合征在类风湿关节炎（RA）、强直性脊柱炎（AS）和银屑病关节炎（PsA）患者中的流行情况。
连续招募 2009 年 7 月至 11 月期间在我院门诊就诊的 RA、AS 或 PsA 患者，进行动脉粥样硬化风险因素和代谢综合征的研究，代谢综合征按照 2009 年联合声明，采用亚洲中心性肥胖标准定义。
共纳入 930 例患者（699 例 RA、122 例 AS、109 例 PsA；70%为女性，平均年龄 51.1±12.7 岁）。RA、AS 和 PsA 患者的平均病程分别为 5.3±5.4、6.0±5.6 和 3.6±3.1 年。与 RA（20%）或 AS（11%）相比，PsA（38%）患者代谢综合征的患病率显著更高（P<0.001）。与年龄和性别匹配的对照组相比，代谢综合征的比值比（OR）分别为 0.98（95%置信区间[95%CI]0.78-1.23，P=0.88）、0.59（95%CI 0.30-1.15，P=0.12）和 2.68（95%CI 1.60-4.50，P<0.001）。与 RA 和 AS 相比，PsA 患者的空腹血糖受损（30%；P<0.001）、低高密度脂蛋白（HDL）胆固醇（33%；P<0.001）、高三酰甘油血症（21%；P=0.008）、中心性肥胖（65%；P<0.001）和高血压（56%；P=0.045）的患病率更高。在逻辑回归模型中，与 RA 或 AS 相比，PsA 患者代谢综合征的调整后 OR 为 2.44（95%CI 1.48-4.01，P<0.001）。中心性肥胖、空腹血糖受损、高三酰甘油血症和低 HDL 胆固醇的调整后 OR 也在 PsA 患者中显著更高。
与普通人群相比，PsA 患者，而非 RA 或 AS 患者，代谢综合征的患病率显著更高。在所研究的 3 种疾病中，PsA 的代谢综合征患病率最高，且与最高的心血管风险相关。
