Background Low-grade inflammation is a risk factor for coronary artery disease. Yet, clinical data on patients with inherited auto-inflammation are limited.
Objectives To assess the natural progression of cardiovascular and metabolic risk among participants with familial Mediterranean Fever (FMF).
Methods We performed a cross-sectional study of the prevalence of components of the metabolic syndrome at age 17, from the medical database of the Israeli Defense Force from 1973 through 1997.Included were 745 males with FMF, 902 healthy male siblings and a control group of 787,714 participants. A prospective follow-up (mean follow-up >19 years) study traced the incidence of components of the metabolic syndrome and angiography-proven coronary artery disease (CAD) to age 45 years among 57 FMF and 1,568 control army personnel participants.
Results In multivariable multinomial regression analysis adjusted for known confounders of obesity, FMF participants had an odds ratio of 0.65 for occurrence of overweight (95%CI=0.44-0.96,p=0.03) and 0.66 (95%CI=0.48-0.92,p=0.012) for hypertension-range blood pressure; their siblings tended to obesity (OR=1.48;95%CI=1.04-2.11,p=0.008). In the follow-up arm, Cox-regression multivariable models adjusted for age, birth year, BMI, education, socioeconomic status, country of origin and physical activity yielded hazard ratios of 0.32 (95%CI=0.10-0.82,p=0.002) for incident obesity, 0.49 (95%CI=0.25-0.95,p=0.037) for incident TG≥150mg/dL, 0.56 (95%CI=0.31-0.98,p=0.048) for LDL≥130mg/dL and 2.14 (1.368-3.359,p=0.001) for HDL<40mg/dL for FMF participants compared to controls. In univariate analysis, incident elevated blood pressure was lower among FMF participants (HR=0.49;95%CI=0.23-1.00,p=0.05), while dysglycemia incidence was comparable. There was no evidence for accelarated CAD among FMF patients.
Conclusions FMF was associated with lower rates of most components of the metabolic syndrome compared to normal subjects, with no evidence for accelerated CAD.
Disclosure of Interest : None declared