Background Cardiovascular morbidity and mortality in patients with rheumatoid arthritis (RA) is associated with early atherosclerosis. A possible explanation could be the metabolic syndrome (MetS) and inflammation.
Objectives To evaluate MetS prevalence and the preclinical atherosclerosis in patients with RA.
Methods Two hundred twenty-five patients with RA (190 woman, 35 men) aged 18-59 years were included in this cross-sectional study, 79% of them had positive rheumatoid factor. MetS prevalence was assessed using NCEP ATPIII (2004) definitions (at least three of five characteristics: abdominal obesity, low level of high density lipoproteins cholesterol, elevated triglyceride and fasting glucose levels, high blood pressure). Carotid intima-media thickness was examined by high resolution B-mode ultrasound measurements. Atheromatous plaque was defined as a local intima-medial thickening ≥1,2mm. The levels of CRP and inflammatory cytokine (interleukin - 18) were determined in serum samples by the high sensitive particle-enhanced immunonephelometric assay.
Results MetS was found in 49 (22%) patients with RA (obesity - 39%, low level of high density lipoproteins cholesterol - 56%, elevated triglyceride level - 10%, elevated fasting glucose level - 14%, hypertension - 54%). Patients with MetS were older (52 years versus 48 years without MetS, p=0,003) but had lower RA duration (54 months versus 120 months without MetS, p=0,02). No difference was observed in ESR, CRP levels and DAS28 in groups with and without MetS. Glucocorticoids use did not associate with MetS. Patients with MetS had significantly higher prevalence of carotid plaques (38% versus 20% in patients without MetS, p=0,01), maximal carotid intima-media thickness (1,0 (0,9-1,2)mm versus 0,9 (0,8-1,0)mm, p=0,007) and level of interleukin-18 (79,5 (0,01-213) pg/ml versus 40 (0,01-393) pg/ml, p=0,05).
Conclusions Most frequently criteria of MetS in patients with RA are dyslipoproteinemia and hypertension. MetS is associated with preclinical atherosclerosis and higher level of proinflammatory interleukin-18.
Disclosure of Interest None Declared