Background Patients with rheumatoid arthritis (RA) often develop wide spectrum of co-morbidities and metabolic changes, particularly involving hepatobiliary system (HBS) which can influence the safety efficacy of the RA pharmacological treatment.
Objectives To determine the metabolic syndrome (MC) prevalence according to WHO (1998) and IDF (2005) classifications and its influence on HBS damage development in RA patients.
Methods We investigated MS criteria and state of the HBS in 126 RA patients (102 women and 24 men, average age 43,82±2,8 years) and 30 subjects (control group) without autoimmune and inflammatory diseases (25 women and 5 men, average age 42,4±2,6 years). RA was diagnosed according to ARA criteria (1987); patients with hepatitis, alcohol abuse, >55 years old were not included. MS was diagnosed according to WHO (1998) and IDF (2005) criteria; HBS was investigated by ultrasound technique and biochemistry tests.
Results Three criteria of MS according to WHO classification were diagnosed in 28,75% RA patients and 10,0% of control group (p<0,01), 2 criteria - in 12,70% patients and 3,33% of the control group (p<0,05); according to IDF classification 3 MS criteria were found in 28,57% RA patients and 10,0% healthy subject (p<0,01); 2 criteria - in 15,08% patients and 3,33% of control group (p<0,05). In 91,4% RA patient with MS the signs of HBS damage were diagnosed by ultrasound: most frequently liver steatosis was found (grade II- in 50,0% and grade III - in 31,25% of patients). The same changes of liver were diagnosed less frequently in patients with RA without MS (20,0% and 13,85% accordingly, p<0,05), in this group less severe liver damage (liver steatosis grade I) was the most frequent diagnosis (found in 40,0% of the group).
Conclusions Both WHO (1998) and IDF (2005) classification MS criteria have the same diagnostic value for the RA patients. MS develops significantly more frequent in patients with RA than in control group at the same age group (<55 years old). The combination of 2 and 3 MS criteria is characteristic for RA patients. RA patients with MS demonstrate more advanced liver steatosis comparing to RA patients without MS.
Disclosure of Interest None declared