AB1286 EVALUATION OF CARDIOVASCULAR RISK FACTORS AND PREVALENCE OF METABOLIC SYNDROME IN PATIENTSWITH DIAGNOSIS OF ANKYLOSING SPONDYLITIS:
Authors: Severino Correia Do Prado Neto, Érika Carvalho de Aquino, Jozelia Rêgo, Nílzio Da Silva, Fabiana Pina
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> Cardiovascular events are the main causes of mortality in patients with Ankylosing Spondylitis. In addition, a higher prevalence of Metabolic Syndrome is reported in this group. With immunobiological therapy, much progress has been made in controlling the inflammatory process, but the cardiovascular risk remains high. <h3>Objectives:</h3> To evaluate the prevalence of cardiovascular risk factors and Metabolic Syndrome in patients with Ankylosing Spondylitis at the Rheumatology Outpatient Clinic of HC-UFG and to correlate them with epidemiological, clinical, laboratory and radiographic characteristics of the disease. <h3>Methods:</h3> Data from 59 patients were collected in medical records between July and August 2018. Clinical characteristics, cardiovascular risk factors and metabolic components were analyzed. Descriptive analyzes of the data were made, prevalences and their reasons were calculated. The associations between variables were assessed by chi-square test and Fisher's exact test. <h3>Results:</h3> 81.4% were male, 67.8% self-denominated non-whites, average age 46.7 years. Isolated axial joint involvement was the most frequently observed (54.2%). Enthesopathic lesions were identified in 30.51% of the cases. Uveitis had a higher prevalence (22.02%), 4.2 times higher in the subgroup with HLA-B27 positive (p=0.0002). HLA-B27 was present in 67.8%. Advanced sacroiliitis (grades 3 and 4) and syndesmophytosis were identified in 61.1% and 49.2%, respectively, but didn't presented significant correlation with the presence of HLA-B27. 64,4% were using anti-TNF alone or in combination. The majority of the patients (72.9%) were sedentary. Clinical comorbidities were reported in 66.1% of the cases, with dyslipidemia (45.8%), systemic arterial hypertension (37.6%) and diabetes mellitus (13.6%) being the most common. Metabolic Syndrome was diagnosed in 23.7% of the samples. Normal levels of triglycerides and fasting glycemia and lower prevalence of Metabolic Syndrome had a statistically significant association with the presence of HLA-B27 (p=0.006; 0.026 and 0.014, respectively). Patients with HLA-B27 present had 61% lower frequency of Metabolic Syndrome. There was no association between the syndrome and its components with anti-TNF therapy; BASDAI; BASFI; metric evaluation; uveitis; degree of sacroiliitis and syndesmophytosis. <h3>Conclusion:</h3> The prevalence of Metabolic Syndrome was below that is described in other populations. The presence of HLA-B27 was considered a protective factor for Metabolic Syndrome, triglyceride levels and fasting glycemia. This finding may be related to the presence of several HLA-B27 alleles, usually non-subtyped, and to the great ethnic miscegenation of the Brazilian population. Our observation suggests that spondylitics should be routinely evaluated for cardiovascular risk factors. <h3>References</h3> [1] Maia, DG, et al. Metabolic Syndrome in patients with ankylosing spondylitis receiving anti-TNF alfa therapy: association with predictors of cardiovascular risk. Clin Rheumatology 2011;36(10):2371-76. [2] Fiorillo, MT, et al. CD8+ T-cell autoreactivity to an HLA-B27–restricted self-epitope correlates with ankylosing spondylitis. The Journal of Clinical Investigation 2000;106(1):47-53. <h3>Disclosure of Interests:</h3> None declared