Background Metabolic syndrome (MetS) is a metabolic disorder whose causes are: central obesity, hyperglycemia, dyslipidemia, and hypertension. In ankylosing spondylitis (AS), the prevalence of MetS appears to be high, suggesting that systemic inflammation and therapeutic used play a role in the development of MetS.
Objectives The aim of our study was to determine the prevalence of MS in AS, to identify factors associated with its presence, and to evaluate the influence of treatment used on its occurrence.
Methods The prevalence of MetS was assessed cross-sectionally in 103 patients with AS fulfilling the modified New York criteria and collected in the Rheumatology Department of the University Hospital Hassan II of Fez. This study was conducted over a period of 18-months (September 2012- March 2014). The assessment of the prevalence of MS in these patients was established using the definition of NCEP/ATP III 2005 since it is the most commonly used in the literature.
Results The average age of patients was 38.62±13.330, with a male predominance (67%). 75% of patients are aged under 60 year-old. The median duration of the course of the disease was 7.11 years. The MetS is present in 34% of patients according to the definition used. It is associated with a Young-Onset disease (p=0.016), female gender (p=0.041), professional inactivity (p=0.015), disease activity assessed by ASDAS (p=0.039) and duration of disease progression (0.04)After multivariate logistic regression only female sex was identified as an independent predictor factor of MetS in patients with AS (OR=0,42; IC 95% [0,18-1,006]; p=0,041).
Conclusions Our findings showed a greater prevalence of MetS in AS female patients than in male patients. Age, disease activity, functional impact of the disease and the therapeutic use include NSAIDs did not appear to be related to the development of MetS in the population of patients studied. Further studies on a larger scale and covering a larger population with AS are needed to assess the association between chronic inflammation in AS and MetS, and to determine the effect of biological therapy in the development of the MetS.
Domenico Malesci, Alferio Niglio, Gianna Angela Mennillo & al. High prevalence of metabolic syndrome in patients with ankylosing spondylitis. Clin Rheumatol (2007) 26:710–714.
Pehlevan S, Yetkin DO, Bahadır C, Goktay F, Pehlevan Y, Kayatas K, Ince N. Increased prevalence of metabolic syndrome in patients with psoriatic arthritis. Metab Syndr Relat Disord. 2014 Feb;12(1):43-8.
Divecha H, Sattar N, Rumley A, Cherry L, Loe GD, Sturrock R(2005). Cardiovascular risk parameters in men with ankylosing spondylitis in comparison with non-inflammatory control subjects: relevance of systemic inflammation. Clin Sci (Lond)109:171–176.
Han C, Robinson DW, Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 2006; 33: 2167-72.
Acknowledgements To all membrs of the departement group of rheumatology and epidemiology, and we think all the patients and their families for the participation in this study.
Disclosure of Interest None declared