OP0089 METABOLIC SYNDROME IS COMMON AROUND THE TIME OF EARLY RHEUMATOID ARTHRITIS DIAGNOSIS AND ASSOCIATIONS VARY BY SEX AND MENOPAUSAL STATUS: RESULTS FROM THE CANADIAN EARLY ARTHRITIS COHORT
Authors: Bindee Kuriya, Orit Schieir, Marie-France Valois, Janet Pope, Gilles Boire, Louis Bessette, Glen Hazlewood, Carter Thorne, Diane Tin, Carol Hitchon, Susan J. Bartlett, Edward Keystone, Vivian Bykerk, Lillian Barra
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Prevalence studies of metabolic syndrome (MetS) in early rheumatoid arthritis (ERA) are sparse and estimates are variable. Differences by sex and menopausal status have not been formally assessed. <h3>Objectives</h3> We estimated prevalence and factors associated with MetS in ERA patients treated in routine practice settings. Variations by sex, and by menopausal status were also examined. <h3>Methods</h3> Cross-sectional data were analyzed from patients meeting 1987 or 2010 ACR/EULAR RA criteria enrolled in the Canadian Early Arthritis Cohort (CATCH) from January 2007-March 2017. CATCH is a prospective multicenter observational study of patients diagnosed and treated for early inflammatory arthritis (symptoms &lt; 1 year) by a rheumatologist. Participants completed standardized clinical assessments and patient-reported outcome measures. Laboratory testing of metabolic parameters was encouraged, but left to the discretion of the rheumatologist. MetS was defined according to modified WHO criteria<sup>1</sup> as ≥ 2 of the following: body mass index (BMI) ≥ 30, hypertension, low high-density lipoprotein (HDL) cholesterol, dyslipidemia, or impaired glucose intolerance (IGT)<sup>1</sup>. Univariate and multivariable logistic regression was used to estimate crude and adjusted associations between baseline demographic, clinical and lifestyle variables with prevalent MetS in men and in women, respectively. <h3>Results</h3> The sample included 1543 participants; 71% were female and mean(SD) age was 54 (15) years. 476 (31%) of the total sample met criteria for MetS. Participants with MetS were older, more frequently past smokers and reported more comorbid conditions, including cardiovascular disease (CVD) (p&lt;0.0001). MetS prevalence was higher in men (42%) than women (26%, p&lt;0.0001) and higher in post-menopausal (33%) vs. pre-menopausal women (15%, p&lt;0.0001). Post-menopausal women had a higher frequency of hypertension (65%), IGT (32%) and dyslipidemia (21%) compared to pre-menopausal women (p&lt;0.001). In multivariable logistic regression MetS was negatively associated with seropositivity and pulmonary disease in men; with corticosteroid use in menopausal women; and with psychiatric comorbidity in pre-menopausal women. <h3>Conclusion</h3> Approximately 1 in 3 ERA patients met crietria for MetS. Though men had a higher prevalence of MetS and individual MetS components, post-menopausal women had a similar MetS profile as men, and should equally be considered high risk for CVD development. Characteristics and associations with MetS differed in men and women suggesting sex-specific variations are important considerations for comorbidity screening and surveillance of CVD outcomes in ERA. <h3>Reference</h3> [1] Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15(7):539-53. <h3>Acknowledgement</h3> Sponsors: Amgen &amp; Pfizer-Founding sponsors 2007+; AbbVie 2011+; Medexus 2013+;EliLilly2016+, Merck Canada 2017+, Hoffmann-LaRoche &amp; Janssen Biotect 2011-2016, UCB &amp; BMS 2011-2018, Sanofi-Genzyme 2016-2017. <h3>Disclosure of Interests</h3> Bindee Kuriya Consultant for: Advisory Board Member: Abbvie, Sanofi Genzyme, Eli Lilly, Pfizer Canada, Roche, Orit Schieir: None declared, Marie-France Valois: None declared, Janet Pope Consultant for: Eli Lilly and Company, Gilles Boire Grant/research support from: Investigator-initiated studies: Amgen, Abbvie, BMS, Eli Lilly, Merck, Novartis, Pfizer, Consultant for: Advisory boards: Amgen, BMS, Celgene, Eli Lilly, Pfizer, Speakers bureau: Merck, BMS, Pfizer, Louis Bessette Grant/research support from: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Consultant for: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Speakers bureau: Amgen, BMS, Janssen, Roche, UCB, AbbVie, Pfizer, Merck, Celgene, Sanofi, Lilly, Novartis, Glen Hazlewood : None declared, Carter Thorne Grant/research support from: Investigator-initiated studies: Amgen, Pfizer. RCTs: Abbvie, Celgene, CaREBiodam, Novartis, Pfizer, Consultant for: Advisory board: Abbvie, Amgen, Celgene, Lilly, Medexus/Medac, Merck, Novartis, Pfizer, Sanofi. Consultant: Abbvie, Centocor, Janssen, Lilly, Medexus/Medac, Pfizer, Speakers bureau: Medexus/Medac, Diane Tin: None declared, CArol Hitchon Grant/research support from: Pfizer, UCB (unrelated studies), Susan J. Bartlett Consultant for: Pfizer, UCB, Lilly, Novartis, Merck, Jansen, Abbvie, Edward Keystone Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, F. Hoffmann-La Roche Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Pfizer Pharmaceuticals, Sanofi-Aventis, Consultant for: AbbVie, Amgen, AstraZeneca Pharma, Biotest, Bristol-Myers Squibb Company, Celltrion, Crescendo Bioscience, F. Hoffmann-La Roche Inc, Genentech Inc, Gilead, Janssen Inc, Lilly Pharmaceuticals, Merck, Pfizer Pharmaceuticals, Sandoz, UCB., Speakers bureau: Amgen, AbbVie, Bristol-Myers Squibb Canada, F. Hoffmann-La Roche Inc., Janssen Inc., Merck, Pfizer Pharmaceuticals, Sanofi Genzyme, UCB, Vivian Bykerk Grant/research support from: Mallinckrodt, BMS, Crescendo Biosciences, Sanofi/Regeneron., Consultant for: Amgen, Pfizer, UCB, Scipher, Sanofi/Genzyme/Regeneron, Lillian Barra: None declared