Background The metabolic syndrome (MetS) is a cluster of risk factors of cardiovascular disease (CVD) and identifies additional cardiovascular risk beyond the sum of its individual components. The data about MetS prevelance are limited in ankylosing spondylitis (AS).
Objectives It is aimed to investigate the prevalence of MetS and its possible relationship with disease activity and anti-tumor necrosis factor (anti-TNF) treatment in patients with AS.
Methods 61 patients (male/female: 52/9, mean age 36±9 years, mean disease duration 96±83 months) who met 1984 New York criteria for AS and 20 age- and sex-matched controls without rheumatic disease (male/female: 15/5, mean age 36±8 years) were studied. The individuals who were taking lipid lowering drugs or who previously had a diagnosis of hypothyroidism were excluded. Adult Treatment Panel III of the National Cholesterol Education Program (NCEP-ATP III) and modified World Health Organization (mWHO) criteria were used to define MetS. AS disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional status of patients was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI). Spinal mobility was measured with Bath Ankylosing Spondylitis Metrology Index (BASMI).
Results 30 patients with AS were on anti-TNF-α treatment and 31 patients were on conventional treatment (non-steroidal anti-inflammatory drug, sulfasalazine and methotrexate). 17 (28%) of AS patients were active (BASDAI>4) and 44 (72%) were in remission. 5 (16.7%) patients who were treated with anti-TNF agent and 12 (38.7%) patients who were treated with conventional medications had active disease (p=0.055). The MetS according to NCEP-ATP III criteria was found in 8 (13.1%) of patients with AS and in 6 (30%) of controls (p=0.083). The MetS according to mWHO criteria was found in 12 (19.7%) of patients with AS and in 7 (35%) of controls (p=0.160). While 5 (16.7%) of the patients on anti-TNF treatment had MetS, 3 (9.7%) of the patients on conventional treatment had MetS according to NCEP-ATP III criteria (p=0,419). According to mWHO criteria 6 (20%) of the patients on anti-TNF treatment and 6 (19.4%) of the patients on conventional treatment had MetS (p=0.949). While 3 (17.6%) of the patients who had active disease had MetS, 5 (11.4%) of the patients in remission had MetS according to NCEP-ATP III criteria (p=0,515). According to mWHO criteria 4 (23.5%) of the patients who had active disease and 8 (18.2%) of the patients in remission had MetS (p=0.638). There was no statistically significant difference between the patients on anti-TNF treatment and the patients on conventional treatment in terms of MetS components. There was also no statistically significant difference between NCEP-ATP III criteria and mWHO criteria in terms of detecting MetS (p=0.22) and there was a good concordance between them (kappa=0.644, p<0.001). There was a weak correlation between BASFI and HOMA index (r=0.256, p=0.046).
Conclusions This study showed that the prevalence of the MetS was not increased and there was no relationship between the prevalence of Mets and anti-TNF treatment and disease activity in AS patient.
Disclosure of Interest None Declared
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