Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Italy.
Department of Clinical and Experimental Medicine, Rheumatology Section, University of Campania Luigi Vanvitelli, Naples, Italy.
Clin Exp Rheumatol. 2021 Sep-Oct;39(5):995-1002. doi: 10.55563/clinexprheumatol/5r53em. Epub 2020 Dec 4.
In rheumatoid arthritis (RA), "traditional" cardiovascular (CV) risk factors continue to be underdiagnosed and undertreated, thus increasing the risk of developing atherosclerosis. In this work, we evaluated the occurrence and predictive factors of "traditional" cardiovascular risk factors, with a focus on high blood pressure (HBP), type 2 diabetes (T2D), and metabolic syndrome (MetS), in participants with RA, in a 3-year, multicentre, prospective, observational study.
To assess the occurrence and predictive factors of HBP, T2D, and MetS, consecutive participants with RA, admitted to Italian Rheumatology Units, were evaluated in the GIRRCS (Gruppo Italiano di Ricerca in Reumatologia Clinica e Sperimentale) cohort, a 3-year, multicentre, prospective, observational study.
In the present evaluation, 841 participants, who were fully followed up with 3-year of prospective follow-up were assessed. At the end of follow-up, a significant increased incidence of HBP, T2D, and MetS was recorded. Assessing predictive factors, the mean values of C-reactive protein during the follow-up were independent predictors of occurrence of those comorbidities, whereas participants maintaining remission showed a significant lower risk. Furthermore, therapy with hydroxychloroquine (HCQ) reduced the risk of occurrence of T2D and MetS.
An increased incidence of HBP, T2D, and MetS was observed in assessed participants, prospectively followed-up. Furthermore, the analysis of predictive factors suggested that the rheumatoid pro-inflammatory process could increase the occurrence of these comorbidities. Conversely, metabolic and cardiovascular benefits of maintaining remission as well as of therapy with HCQ were reported.
在类风湿关节炎（RA）中，“传统”心血管（CV）危险因素仍未得到充分诊断和治疗，从而增加了动脉粥样硬化的风险。在这项工作中，我们评估了 RA 患者中“传统”心血管危险因素（重点是高血压（HBP）、2 型糖尿病（T2D）和代谢综合征（MetS））的发生和预测因素，这是一项为期 3 年、多中心、前瞻性、观察性研究。
为了评估 HBP、T2D 和 MetS 的发生和预测因素，连续纳入意大利风湿病单位的 RA 患者，在 GIRRCS（意大利临床和实验风湿病研究组）队列中进行评估，这是一项为期 3 年、多中心、前瞻性、观察性研究。
在本次评估中，对 841 名患者进行了评估，这些患者接受了为期 3 年的前瞻性随访。随访结束时，记录到 HBP、T2D 和 MetS 的发病率显著增加。评估预测因素时，随访期间 C 反应蛋白的平均值是这些合并症发生的独立预测因素，而维持缓解的患者风险显著降低。此外，羟氯喹（HCQ）治疗降低了 T2D 和 MetS 的发病风险。
在评估的患者中，前瞻性随访观察到 HBP、T2D 和 MetS 的发病率增加。此外，预测因素分析表明，类风湿炎症过程可增加这些合并症的发生。相反，维持缓解以及 HCQ 治疗的代谢和心血管获益得到了报道。
