The metabolic syndrome is amplified in hypothyroid rheumatoid arthritis patients: a cross-sectional study
- H G Raterman1,
- I C van Eijk2,
- A E Voskuyl1,
- M J L Peters1,
- B A C Dijkmans1,2,
- V P van Halm1,
- S Simsek3,
- W F Lems1,
- M T Nurmohamed1,2,3
- 1Department of Rheumatology, VU University Medical Center, Amsterdam, The Netherlands
- 2Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The Netherlands
- 3Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Correspondence to Dr M T Nurmohamed, VU University Medical Centre, Departments of Internal Medicine and Rheumatology, PO Box 7057, 1007 MB Amsterdam, The Netherlands; m.nurmohamed{at}janvanbreemen.nl
- Accepted 14 December 2008
- Published Online First 22 December 2008
Abstract
Objectives: Rheumatoid arthritis (RA) patients are at increased risk of cardiovascular disease (CVD), which is even more pronounced in hypothyroid RA patients. An unfavourable cardiovascular risk profile conferred by a higher prevalence of the metabolic syndrome (MetS) and a higher Framingham risk score might explain this amplified cardiovascular morbidity. This study compared first, MetS (features) and second, the Framingham 10-year CVD risk in RA patients with hypothyroidism compared with euthyroid RA patients.
Methods: RA patients participating in the CARRÉ investigation were divided into two groups: hypothyroid and euthyroid RA patients. MetS according to the National Cholesterol Education Program Third Adult Treatment Panel criteria and the Framingham risk score was compared between hypothyroid and non-hypothyroid CVD event-free RA patients.
Results: In total, 257 RA patients were included: 236 with RA (91.8%) and 21 with hypothyroid RA (8.2%), respectively. The prevalence of the MetS was significantly higher in hypothyroid RA patients (43%) compared with RA patients (20%). Moreover, female hypothyroid RA patients had a higher Framingham risk score compared with euthyroid RA patients. With RA patients as the reference category, the age and gender-adjusted prevalence odds ratio for the MetS was 3.5 (95% CI 1.3 to 9.1) in hypothyroid RA.
Conclusions: Hypothyroid RA patients, particularly female patients, have a more unfavourable cardiovascular risk profile, reflected by an increased prevalence of the MetS and higher Framingham score, than euthyroid RA patients, suggesting a greater need for cardiovascular risk management in these patients to prevent future CVD events.
Footnotes
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HGR and ICvE contributed equally to the article.
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Competing interests None.
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Ethics approval The Jan van Breemen Institute received approval for this study from the local medical ethics committee.
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Patient consent Obtained.
