Background: Metabolic syndrome is recognized as an independent cardiovascular risk factor. Autoimmune diseases are associated with higher incidence of cardiovascular diseases (CVD) with respect to the general population. Systemic inflammation seems also to play a fundamental role in increasing this risk. Objectives: To define the prevalence of the Metabolic Syndrome (MetSyn) and the influence of systemic inflammation on the MetSyn parameters in a cohort of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) patients. Methods: 200 RA, 103 SLE and 113 SSc patients attending the care facilities of the Division of Rheumatology of the Catholic University of Rome, entered into the study. The criteria adopted by the Adult Treatment Panel III report (ATP III) from the National Institute of Health were used to define the presence of MetSyn in the RA, SLE and SSc patients cohorts and in 185 patients with osteoarthritis (OA) taken as controls. Clinical, biochemical and immunological parameters were assessed in all patients. Results: SLE patients, as expected, were younger (mean age 41.2 ± 13.4 years vs 55.4 ± 11.3 years in SSc, 62.7 ± 10.2 years in RA and 64.0 ± 7.6 years in OA). The prevalence of the MetSyn in RA was 24%, 18% in SLE and 12% in SSc compared to 21% in OA. The prevalence of the MetSyn was significantly lower in SSc vs RA patients (p=0.0133). No significant differences were found between the other groups. Among the various parameters defining MetSyn, hypertension and low HDL levels were significantly less frequent in SSc (24% and 23% respectively) vs RA (45% and 39%; p=0.0003 and 0.004 respectively) and SLE patients (39% and 38%; p=0.02 and 0.017 respectively). Instead, percentage of patients with increased BMI in SSc cohort (47%) was similar to RA (41%) and OA (50%) patients and significantly higher than SLE (31%; p=0.01). Hypertension in SLE (39%) was as frequent as in RA (45%) and OA patients (39%), despite the younger age, and more frequent than in SSc patients (24%; p=0.02). Considering systemic inflammation, as expected, we found that RA patients had higher levels of ESR and CRP than all the others groups, whose values were similar. Dividing patients in those with or without MetSyn, we found that RA patients with MetSyn had higher levels of CRP than patients without MetSyn (26.6±30.0 vs 18.5±21.6; p=0.041). The same results were found in SLE (CRP 16.5±32.0 vs 4.8±5.4; p=0.036). No differences for ESR and CRP were seen in SSc patients with and without MetSyn neither in OA patients. Conclusion: Given the similar presence of the MetSyn, the higher cardiovascular risk in RA vs OA, can be mostly explained by the ongoing inflammation. The same applies to SLE, but not to SSc, an autoimmune disease with a low inflammation state.
Metabolic syndrome in autoimmune diseases: prevalence and relationship with the inflammatory burden
Gremese E;
2006-01-01
Abstract
Background: Metabolic syndrome is recognized as an independent cardiovascular risk factor. Autoimmune diseases are associated with higher incidence of cardiovascular diseases (CVD) with respect to the general population. Systemic inflammation seems also to play a fundamental role in increasing this risk. Objectives: To define the prevalence of the Metabolic Syndrome (MetSyn) and the influence of systemic inflammation on the MetSyn parameters in a cohort of rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) patients. Methods: 200 RA, 103 SLE and 113 SSc patients attending the care facilities of the Division of Rheumatology of the Catholic University of Rome, entered into the study. The criteria adopted by the Adult Treatment Panel III report (ATP III) from the National Institute of Health were used to define the presence of MetSyn in the RA, SLE and SSc patients cohorts and in 185 patients with osteoarthritis (OA) taken as controls. Clinical, biochemical and immunological parameters were assessed in all patients. Results: SLE patients, as expected, were younger (mean age 41.2 ± 13.4 years vs 55.4 ± 11.3 years in SSc, 62.7 ± 10.2 years in RA and 64.0 ± 7.6 years in OA). The prevalence of the MetSyn in RA was 24%, 18% in SLE and 12% in SSc compared to 21% in OA. The prevalence of the MetSyn was significantly lower in SSc vs RA patients (p=0.0133). No significant differences were found between the other groups. Among the various parameters defining MetSyn, hypertension and low HDL levels were significantly less frequent in SSc (24% and 23% respectively) vs RA (45% and 39%; p=0.0003 and 0.004 respectively) and SLE patients (39% and 38%; p=0.02 and 0.017 respectively). Instead, percentage of patients with increased BMI in SSc cohort (47%) was similar to RA (41%) and OA (50%) patients and significantly higher than SLE (31%; p=0.01). Hypertension in SLE (39%) was as frequent as in RA (45%) and OA patients (39%), despite the younger age, and more frequent than in SSc patients (24%; p=0.02). Considering systemic inflammation, as expected, we found that RA patients had higher levels of ESR and CRP than all the others groups, whose values were similar. Dividing patients in those with or without MetSyn, we found that RA patients with MetSyn had higher levels of CRP than patients without MetSyn (26.6±30.0 vs 18.5±21.6; p=0.041). The same results were found in SLE (CRP 16.5±32.0 vs 4.8±5.4; p=0.036). No differences for ESR and CRP were seen in SSc patients with and without MetSyn neither in OA patients. Conclusion: Given the similar presence of the MetSyn, the higher cardiovascular risk in RA vs OA, can be mostly explained by the ongoing inflammation. The same applies to SLE, but not to SSc, an autoimmune disease with a low inflammation state.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
