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The metabolic syndrome is amplified in hypothyroid rheumatoid arthritis patients: a cross sectional study
  1. H G Raterman (h.raterman{at}vumc.nl)
  1. VU University Medical Center, Netherlands
    1. I C van Eijk (i.v.eijk{at}janvanbreemen.nl)
    1. Jan van Breemen Institute, Netherlands
      1. A E Voskuyl (ae.voskuyl{at}vumc.nl)
      1. VU University Medical Center, Netherlands
        1. M J L Peters (m.peters{at}janvanbreemen.nl)
        1. VU University Medical Center, Netherlands
          1. B A C Dijkmans (bac.dijkmans{at}vumc.nl)
          1. VU University Medical Center, Netherlands
            1. V P van Halm (v.halm{at}chello.nl)
            1. VU University Medical Center, Netherlands
              1. S Simsek (simsek{at}vumc.nl)
              1. VU University Medical Center, Netherlands
                1. W F lems (wf.lems{at}vumc.nl)
                1. VU University Medical Center, Netherlands
                  1. M T Nurmohamed (m.nurmohamed{at}janvanbreemen.nl)
                  1. VU University Medical Center, Netherlands

                    Abstract

                    Objectives: Rheumatoid arthritis (RA) patients are at increased risk for cardiovascular disease (CVD), which is even more pronounced in hypothyroid RA patients. An unfavourable cardiovascular risk profile conferred by a higher prevalence of metabolic syndrome (MetS) and a higher Framingham risk score might explain this amplified cardiovascular morbidity. Hence, this study compared firstly, MetS (features) and, secondly, the Framingham 10-year CVD risk in RA patients with hypothyroidism compared to euthyroid RA patients.

                    Methods: RA patients participating in the CARRÉ investigation were divided in two groups: hypothyroid and euthyroid RA patients. MetS according to the NCEP ATIII-criteria and the Framingham risk score were compared between hypothyroid and non hypothyroid CVD event-free RA patients.

                    Results: In total, 257 RA patients were included: 236 RA (91.8%) and 21 hypothyroid RA (8.2%), respectively. The prevalence of MetS was significantly higher in hypothyroid RA patients (43%) compared to RA patients (20%). Moreover, female hypothyroid RA patients had a higher, Framingham risk score compared to euthyroid RA patients. With RA patients as reference category, the age and gender adjusted prevalence OR for MetS was 3.5 (95%-CI: 1.3 – 9.1) in hypothyroid RA.

                    Conclusions: Hypothyroid RA patients, particularly female patients, have a more unfavourable cardiovascular risk profile, reflected by increased prevalence of MetS and higher Framingham score, than euthyroid RA patients, suggesting a higher need for cardiovascular risk management in these patients to prevent future CVD events.

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