AB1260 CHARACTERISTICS OF METABOLIC SYNDROME IN AN ASIAN COHORT OF PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Claire Teo Min-LI, Elampirai Elangovan, Chia Mun Woo, Chien Joo Lim, Khai Pang Leong, Ee Tzun Koh
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Metabolic syndrome (MS), the concurrence of hypertension, abdominal obesity, dyslipidemia and glucose intolerance, is an important risk factor for type II diabetes mellitus (T2DM) and cardiovascular disease (CVD). CVD is a leading cause of morbidity and mortality in patients with rheumatoid arthritis (RA). Studies in RA suggest that inflammation and glucocorticoid use predispose to MS, and that MS is associated with active disease. <h3>Objectives</h3> To investigate the prevalence and characteristics of MS in our cohort of RA patients. <h3>Methods</h3> A total of 409 patients who fulfilled the 1987 ACR criteria for RA and with complete data for classification of MS were included. MS was defined according to the Adult Treatment Panel III report of the National Cholesterol Education Programme (NCEP/ATP III). Information related to demographics, disease onset, serologies, disease activity and treatment was collected. Independent t-test or Mann-Whitney U test was used to compare continuous quantitative data, while Pearson Chi-square or Fisher Exact test for categorical data. Logistic regression was used to identify factors associated with of MS. All the statistical tests were two sided, and p value &lt;0.05 was considered as statistically significant. <h3>Results</h3> Fifty-two patients (12.7%) fulfilled the criteria for MS. Most of the patients in the cohort were female (85.3%) and non-smokers (84.6%). The mean age was 60.5±11.09 years and mean BMI 23.67±5.06. The patients with MS were significantly older (age 64.21+8.63 vs 59.96±11.32, p=0.010). The mean disease duration was 14.09±9.74 years. Rheumatoid factor and anti-cyclic citrullinated peptide antibody were present in 80.0% and 95.1% respectively. 4.4% of them had a history of CVD or stroke/transient ischaemic attack but the prevalence was the same in patients with and without MS. Comparing the two groups, there was no significant difference in the history of ever-smoking (15.4% vs 15.4%, p=0.699), disease duration (16.44±10.11 vs 13.72±9.66 years, p=0.060), cumulative glucocorticoid use (p=0.649), DAS28 score (2.12±1.09 vs 2.11±1.24, p=0.458) and HAQ score (0.13 vs 0.13, p=0.767). There was also no significant difference in the use of methotrexate, leflunomide or biologics. The commonest MS criteria fulfilled were hypertension (88.5%) and dyslipidaemia (84.6%). 46.2% of the patients with MS had T2DM. Males were less likely to have MS than females [adj. OR (95%CI): 0.039 (0.005, 0.292), p=0.002]. <h3>Conclusion</h3> MS is found in 12.7% of our RA patients and they were significantly older than those without MS. In our study, MS does not have a significant association with RA disease activity, disease duration, glucocorticoid usage or disease modifying anti-rheumatic treatment. <h3>References</h3> [1] Rostom S, et al. Metabolic syndrome in rheumatoid arthritis: case control study. BMC Musculoskeletal Disorders. 2013 Apr 26;14:147. [2] Tantayakom P, et al. Metabolic syndrome is associated with disease activity in patients with rheumatoid arthritis. Joint Bone Spine. 2016 Oct;83(5):563 <h3>Disclosure of Interests</h3> None declared