Background Metabolic syndrome (MeS) is associated with an increased, independent risk for cardiovascular disease (CVD) in patients with rheumatoid arthritis (RA). Adipose tissue is active endocrine organ that produces hormone-like substances –adipokines, affecting to the developmentof CVD. The influence of adipokines to the chronic inflammation and metabolic abnormalities in patients with RA is unclear.
Objectives To investigate the frequency of MeS and its components in pts with RA, the associations between adipokines levels and RA activity.
Methods Included 69 ptswith RA (F: 51 M:18), 57 [46-64] years old, disease duration 24[6-72] months). MeS was defined according to the criteria Adult Treatment Panel III criteria: fasting hyperglycemia (≥6,1mmol/l), abdominal obesity (waist circumference >102 cm in men, >88 cm in women), hypertriglyceridemia (≥1,7mmol/l), low level HDL (<1,0mmol/l in men, <1,3 mmol/l inwomen), hypertension (≥130/85 hgmm). The RA activity was determined by the index DAS28, SDAI. The adipokines concentrations were assessed by ELISA (Diagnostics Biochem Canada Inc.). The normal range of serum adiponectin according to manufacturer’s data was 9,5-13,2 ng/ml; the normal range of serum leptin according to manufacturer’s data was 3,8-7,4 ng/ml.
Results MeS has beenfound in 12 (17,4%) pts with RA. Pts with RA and MeS had higher DAS28 compared with RA pts without the MeS (5,8[4,9-6,7] vs 5,1[4,5-5,8], p<0,05). Ptswith RAare dividedinto two groups: first-with early RA (n = 27) (disease duration 6.6[6-8] months), the second - with the established RA (n = 42) (70.5 disease duration [24, 114] months). The frequency of MeS and this components with early and established RA presented in the table. The frequency of MeS in early RA was 2 times higher than in the long-term (25,9% vs 11, 9%), but the differences were not significant (p = 0.1). No significant differences in the incidence of MeS components in group 1 and 2 were also revealed. In the group of pts with early RA showed the negative correlation between serum levels of adiponectin with DAS28(r=-0,38), SDAI(r= -0,52), ESR (r=-0,45) (p<0,05 all cases), positive correlationwith the levels ofHDL-C (r=0,5), betweenleptinlevelsandDAS28 (r=0,51), ESR (r=0,65), levels TC(r=0,53), glucose levels (r=0,59) (p<0,05 all cases). In the second group of pts correlation between adipokines, markers of activity and metabolic abnormalities were not detected.
Conclusions The higher prevalence of the MeS and its components, the relationship of adipokines with disease activity in early RA suggests role of inflammation in the development of cardiovascular disease in those patients. Further studies are required to determine whether improving disease control can reverse or improve the clustering of MeS criteria in this population.
Disclosure of Interest None Declared
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