Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Rheumatoid
arthritis (RA) is a chronic systemic inflammatory disease involving articular
and extra-articular systems, including cardiovascular (CVS), respiratory, as
well as hematologic systems, etc. Among extra-articular manifestations, CVS
disease is a leading cause of morbidity and mortality in the recent years. Patients with RA also have increased
risk of metabolic syndrome (MS), compared to general population. Chronic
systemic inflammation from both RA and MS could promote endothelial dysfunction
and atherosclerotic plaques development leading to increase in CVS risk. Our objective was to investigate
the association between MS and disease activity in patients with RA.
Methods:
Siriraj
Rheumatoid Arthritis registry is a prospective cohort study establishing since
May 2011. A total of 267 patients who had complete data in February 2015 were
included in these analyses. All clinical and laboratory data related to disease
activity, functional status, and parameters of MS according to the 2001
National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III)
were collected. For cumulative disease activity, time-adjusted mean (TAM) of disease
activity score (DAS) 28 was calculated. The TAM of DAS28 is the area under a
curve (AUC) of DAS28 plotted against time, divided by the total length of time
from first to last measurement. Univariate and
backward stepwise multivariate analyses were performed to identify factors
associated with MS.
Results: Most (88%) were female with the
mean age ± standard deviation of 59 ± 11.1
years old. MS was found in 43 patients (16%). High blood pressure was the most
prevalent components of MS in both RA with MS and non-MS. Patients with MS had
a significantly lower proportion of patients with remission (time adjusted mean
of disease activity score 28 or DAS28 <
2.6) than those with non-MS (2.3% vs. 16.5%, p = 0.02). Multiple logistic
regression analysis identified 4 independent factors associated with MS
including age [odds ratio (OR) 1.01, 95% confidence
interval (CI) (0.98 to 1.05)], body mass index [OR 1.2, 95% CI 1.1 to 1.3],
educational level ≤ 12 years [OR 5.92, 95% CI 1.47
to 23.83], and disease remission [OR 0.11, 95% CI 0.01 to 0.93]. This model
correctly predicted 84% of cases.
Conclusion:
Disease activity
of RA, body mass index, and educational level are associated with metabolic
syndrome in patients with RA
Table
Odds ratios for
the presence of metabolic syndrome in patients with rheumatoid arthritis
|
|
Univariate analysis
|
Multivariate analysis
|
||||
|
|
OR
|
95% CI
|
P value
|
OR
|
95% CI
|
P value
|
|
Age
|
1.02 |
0.99-1.06 |
0.14 |
1.01 |
0.98-1.05 |
0.44 |
|
Body mass index
|
1.17 |
1.09-1.25 |
< 0.001 |
1.20 |
1.1-1.3 |
< 0.001 |
|
Education level ≤ 12 years
|
3.8 |
1.3-11.1 |
0.02 |
5.92 |
1.47-23.83 |
0.01 |
|
Rituximab use
|
9.69 |
2.22-42.25 |
0.002 |
17.44 |
2.91-104.67 |
0.002 |
|
TAM of DAS28 < 2.6
|
0.12 |
0.16-0.90 |
0.04 |
0.11 |
0.01-0.93 |
0.04 |
CI
= confidence intervals; OR = odds ratio; TAM = time-adjusted mean; DAS 28=
disease activity score28
To cite this abstract in AMA style:
Tantayakom P, Koolvisoot A, Arromdee E, Chiowchanwisawakit P, Muangchan C, Katchamart W. Metabolic Syndrome Is Associated with Disease Activity in Patients with Rheumatoid Arthritis: A Prospective Cohort Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/metabolic-syndrome-is-associated-with-disease-activity-in-patients-with-rheumatoid-arthritis-a-prospective-cohort-study/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/metabolic-syndrome-is-associated-with-disease-activity-in-patients-with-rheumatoid-arthritis-a-prospective-cohort-study/