Characteristics of Metabolic Syndrome in Men and Women with Early Rheumatoid Arthritis

Bindee Kuriya¹, Orit Schieir², Marie-France Valois³, Janet E. Pope⁴, Gilles Boire⁵, Louis Bessette⁶, Carter Thorne⁷, Diane Tin⁸, Carol A Hitchon⁹, Glen Hazlewood¹⁰, Susan J. Bartlett¹¹, Edward C. Keystone¹², Vivian P. Bykerk¹³ and Lillian Barra¹⁴, ¹Rheumatology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada, ²McGill University, Montreal, ON, Canada, ³McGill University, Montreal, QC, Canada, ⁴Department of Medicine, University of Western Ontario, London, ON, Canada, ⁵Rheumatology Division, Centre intégré universitaire de santé et de services sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke and Universite de Sherbrooke, Sherbrooke, QC, Canada, ⁶Division of Rheumatology, Department of Medicine, CHU de Québec-Université Laval, Québec, QC, Canada, ⁷University of Toronto, Newmarket, ON, Canada, ⁸The Arthritis Program, Southlake Regional Health Centre, Newmarket, ON, Canada, ⁹University of Manitoba, Winnipeg, MB, Canada, ¹⁰Departments of Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada, ¹¹Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, ¹²Mount Sinai Hospital, Toronto, ON, Canada, ¹³Hospital for Special Surgery, New York, NY, ¹⁴Medicine, Microbiology and Immunology, The University of Western Ontario, London, ON, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Cardiovascular disease, metabolic syndrome, methotrexate (MTX) and rheumatoid arthritis (RA)

Session Information

Date: Sunday, October 21, 2018

Title: Rheumatoid Arthritis – Diagnosis, Manifestations, and Outcomes Poster I: Comorbidities

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Prevalence and Characteristics of Metabolic Syndrome in Men and Women With Early Rheumatoid Arthritis

B. Kuriya, O. Schieir, M.F. Valois, J.E. Pope, G. Boire, L. Bessette, G. Hazlewood, J.C. Thorne, D. Tin, C. Hitchon, S. Bartlett, E.C. Keystone, V.P. Bykerk and L. Barra, on behalf of CATCH investigators.

Background/Purpose: Metabolic syndrome (MetS) increases the risk of cardiovascular disease (CVD) and is highly prevalent in established RA but data on the prevalence in early RA (ERA) are conflicting. Furthermore, there are limited data on potential differential expression of MetS by sex in RA. Our aim was to estimate the prevalence and characteristics of MetS among men and women with ERA.

Methods: The Canadian Early Arthritis Cohort (CATCH) is a multicenter observational study of ERA patients. Participants (n=1536) with confirmed ERA (symptoms <12 months) and complete baseline data for MetS components were included to estimate the prevalence of MetS according to the 1999 World Health Organization definition, requiring >2 of 5 components (BMI >/= 30, or BP >/= 140/90, or HDL level </=1.0 mmol/L in women or </= 1.0 mmol/L in men, or triglyceride level >/= 2.0 mmol/L, or random glucose >/= 6.1 mmol/L). Sex-stratified logistic regression was used to identify clinical, laboratory and treatment variables associated with MetS.

Results: The study sample was 71% female, mean age was 54 (SD 15) years, mean DAS28-ESR at cohort entry was high 5.1(SD 1.4) and the majority was treated with csDMARDs (87%), at or before, the baseline visit. At baseline, 462 (30%) met criteria for MetS; prevalence was higher in men 180 (41%) than women 282 (26%); p<0.0001. Age and sex stratified prevalence of MetS is shown in the Figure. The most frequent MetS components in men were hypertension (60%), glucose intolerance (39%), obesity (BMI ≥ 30, 36%) and low HDL (36%); and in women were hypertension (47%), obesity (30%) and glucose intolerance (23%). These components were all significantly higher in men than women (p<0.05). In univariable analysis, MetS was significantly associated with higher mean uric acid, creatinine and alanine aminotransferase levels in women; and higher mean creatinine in men. These associations were no longer significant after adjustment in multivariable logistic regression.

Conclusion: The prevalence and characteristics of MetS were different in male and female ERA patients. Further investigation is needed to determine if different strategies for CVD risk management in men and women with ERA and MetS is required.

Figure. Prevalence of MetS at baseline by age group and sex.

Disclosure: B. Kuriya, None; O. Schieir, Other, 2; M. F. Valois, Other, 2; J. E. Pope, AbbVie Inc., 5,Amgen Inc., 5,Bristol-Myers Squibb, 5,Lilly, 5,Merck & Co., 5,Novartis, 5,Pfizer, Inc., 5,Roche, 5,Sanofi, 5,Sandoz, 5,Celltrion, 5,United Chemicals Belgium, 2; G. Boire, Merck & Co., 8, 9,BMS, 8, 9,Pfizer, Inc., 8, 9,Amgen Inc., 9,AbbVie Inc., 9,Novartis, 9,Eli Lilly and Co., 9,Janssen, 9; L. Bessette, Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Lilly, Novartis, 2, 5, 8; C. Thorne, Amgen Inc., 2, 5, 9,Pfizer, Inc., 2, 5, 9,UCB, Inc., 9,AbbVie Inc., 2, 5, 9,Medexus/Medac, 2, 5, 8,Eli Lilly and Co., 9,Merck & Co., 9,Hospira, 5, 9,Janssen, 9,Sanofi Genzyme, 5, 9,Celgene Corporation, 9,CaREBiodam, 9,Centocor, 5,Novartis, 9; D. Tin, None; C. A. Hitchon, None; G. Hazlewood, None; S. J. Bartlett, UCB, Inc., 5,Lilly, 5,Pfizer, Inc., 5,Novartis, 5; E. C. Keystone, AbbVie, Amgen, Bristol-Myers Squibb, F. Hoffmann-La Roche Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Pfizer Pharmaceuticals, Sanofi-Aventis, 2,AbbVie, Amgen, AstraZeneca Pharma, Biotest, Bristol-Myers Squibb Company, Celltrion, Crescendo Bioscience, F. Hoffmann-La Roche Inc, Genentech Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Merck, Pfizer Pharmaceuticals, Sandoz, UCB, 5,Amgen, AbbVie, Bristol-Myers Squibb Canada, F. Hoffmann-La Roche Inc., Janssen Inc., Merck, Pfizer Pharmaceuticals, Sanofi Genzyme, UCB, 8; V. P. Bykerk, Amgen Inc., 2,BMS, 2; L. Barra, None.

To cite this abstract in AMA style:

Kuriya B, Schieir O, Valois MF, Pope JE, Boire G, Bessette L, Thorne C, Tin D, Hitchon CA, Hazlewood G, Bartlett SJ, Keystone EC, Bykerk VP, Barra L. Characteristics of Metabolic Syndrome in Men and Women with Early Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/characteristics-of-metabolic-syndrome-in-men-and-women-with-early-rheumatoid-arthritis/. Accessed .

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