Department of Young Leaders' Program in HealthCare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Nagoya 466-8550, Japan.
Arthritis Res Ther. 2010;12(6):R218. doi: 10.1186/ar3203. Epub 2010 Dec 23.
Rheumatoid arthritis (RA) is associated with increased morbidity and mortality due to cardiovascular disease, and this occurs early in the disease process. The metabolic syndrome (MetS) may contribute to the excess cardiovascular burden observed in RA; however, little information is available regarding MetS in early RA. We aimed to identify the prevalence of MetS and to determine the potential factors associated with the presence of MetS in Vietnamese women with early RA.
A total of 105 consecutive women with early RA (disease duration ≤3 years) and 105 age-matched healthy women were checked for MetS according to six MetS definitions (Joint Consensus, International Diabetes Federation, National Cholesterol Education Program 2004 and 2001, European Group for Study of Insulin Resistance, and World Health Organization). Multivariate logistic regression models were constructed to determine independent predictors of MetS in women with RA.
Prevalence of MetS varied from 16.2% to 40.9% according to the definitions used in women with RA, and was higher (P < 0.001) than in healthy controls (from 10.5% to 22.9%). Among individual components of MetS, differences between women with RA and controls were observed for hypertension (P < 0.001), low high density lipoprotein-cholesterol (HDL-C) levels (P < 0.001), and abdominal obesity (P = 0.019). After adjusting for age and physical activity, higher erythrocyte sedimentation rate (ESR) (odds ratios (OR) = 1.516, 95% confidence interval (CI): 1.073 to 3.195, P = 0.042), disease activity score (DAS28) (OR = 1.736, 95% CI: 1.293 to 2.786, P = 0.019), health assessment questionnaire (HAQ) score (OR = 1.583, 95% CI: 1.195 to 2.367, P = 0.035), and less methotrexate use (OR = 0.736, 95% CI: 0.547 to 0.962, P = 0.024) remained significant independent predictors of the presence of MetS in women with RA.
Women with early RA already had higher prevalence of MetS compared with healthy controls. Higher systemic inflammatory marker, disease activity and disability scores, and less methotrexate use were independent predictors associated with the presence of MetS in women with early RA. These findings suggest that physicians should screen for MetS in women with early RA to control its components and therefore reduce their risk of cardiovascular diseases.
类风湿关节炎（RA）与心血管疾病相关的发病率和死亡率增加有关，并且这种情况发生在疾病早期。代谢综合征（MetS）可能导致 RA 中观察到的心血管负担过重；然而，关于早期 RA 中的 MetS 的信息很少。我们旨在确定 MetS 的患病率，并确定越南早期 RA 女性中与 MetS 存在相关的潜在因素。
根据六种 MetS 定义（联合共识、国际糖尿病联合会、2004 年和 2001 年国家胆固醇教育计划、欧洲胰岛素抵抗研究组和世界卫生组织），对 105 例连续的早期 RA（病程≤3 年）女性和 105 名年龄匹配的健康女性进行了 MetS 检查。建立多元逻辑回归模型以确定 RA 女性 MetS 的独立预测因素。
根据 RA 女性使用的定义，MetS 的患病率从 16.2%到 40.9%不等，并且高于健康对照组（从 10.5%到 22.9%）（P<0.001）。在 MetS 的各个组成部分中，RA 女性与对照组之间存在高血压（P<0.001）、低高密度脂蛋白胆固醇（HDL-C）水平（P<0.001）和腹部肥胖（P=0.019）的差异。调整年龄和体力活动后，较高的红细胞沉降率（ESR）（比值比（OR）=1.516，95%置信区间（CI）：1.073 至 3.195，P=0.042）、疾病活动评分（DAS28）（OR=1.736，95%CI：1.293 至 2.786，P=0.019）、健康评估问卷（HAQ）评分（OR=1.583，95%CI：1.195 至 2.367，P=0.035）和较少使用甲氨蝶呤（OR=0.736，95%CI：0.547 至 0.962，P=0.024）仍然是 RA 女性 MetS 存在的独立预测因素。
早期 RA 女性的 MetS 患病率高于健康对照组。较高的系统性炎症标志物、疾病活动度和残疾评分以及较少使用甲氨蝶呤是与早期 RA 女性 MetS 存在相关的独立预测因素。这些发现表明，医生应在早期 RA 女性中筛查 MetS，以控制其成分，从而降低她们患心血管疾病的风险。
