SAT0085 METABOLIC SYNDROME AND ITS ASSOCIATION WITH RHEUMATIC DISEASES IN PARAGUAYAN PATIENTS
Authors: A. Paats, V. Valinotti, R. Acosta, L. Roman, M. Duarte, O. Centurion, P. De Abreu, T. Martinez, G. Avila, I. Acosta-Colman, S. Cabrera-Villalba
Journal: Annals of the Rheumatic Diseases (2020)

Background: Metabolic syndrome (MS) is associated with increased abdominal adipose tissue and production of inflammatory cytokines. Patients with MS are at increased risk for developing cardiovascular disease and diabetes mellitus, which are among the leading causes of death in chronic rheumatic diseases. Objectives: To characterize patients with rheumatic disease and MS and its association with inflammatory markers. Methods: Descriptive, cross sectional, prospective study, in 3 Paraguayan cohorts of patients with rheumatoid arthritis (RA), systemic sclerosis (SSc) and systemic lupus erythematosus (SLE). This study had two phases: the first one, included a standardized questionnaire according to the variables included in the Cardiovascular Risk project (PINV15-0346), from the Consejo Nacional de Ciencias y Tecnología (CONACYT), and physical examination; the second one included laboratory sample collection performed by a specialized laboratory for serum biomarkers measurement for cardiovascular risk prediction (i.e endothelin, alpha-TNF, E-selectin, t-PA, VCAM, PAI-1 and high sensitivity-CRP levels). MS patients were categorized according to 2007 ALAD criteria. All patients signed informed consent. SPSS Statistics v23 was used for data analysis. Quantitative variables were presented as means and qualitative variables as frequencies. Chi square test was performed for comparisons between dichotomous variables. A p value ≤ 0.05 was used for statistical significance. Results: We included a total of 253 patients, 100 with RA, 100 with SLE and 52 with SSc. Metabolic syndrome was found in 23,58% (50/212). There was no significant difference in MS prevalence between diseases, but there was a higher frequency of increased abdominal circumference in RA and low HDL in SLE. Frequencies for different features of MS in RA, SLE and SSc are detailed in table 1. Table 1. Frequencies of MS component in SLE, SSc and RA. SLE SSc RA p hsCRP 23,52% (16/68) 26,31% (10/38) 42,85% (36/84) 0,027 E-Selectin 5,88% (4/68) 21,05% (8/38) 5,95% (5/84) 0,014 t-PA 0% (0/68) 2,63% (1/38) 5,95% (5/84) 0,111 VCAM 20,58% (14/68) 8,1% (3/37) 0% (0/83) 0,000 TNF-α 7,35% (5/68) 18,42% (7/38) 13,09% (11/84) 0,229 Endotelin 20,58% (14/68) 31,57% (12/38) 19,75% (16/81) 0,192 PAI-1 11,36% (5/44) 0% (0/38) 0% (0/83) 0,002 Table 2. Frequency of high serum inflammatory biomarkers in SLE, RA and SSc. SLE SSc RA p Abdominal circumference criteria 43,4% (43/99) 46,66% (21/46) 64% (64/100) 0,009 Hypertension criteria 67% (67/100) 67,3% (35/52) 55% (55/100) 0,152 HDL criteria 55,22% (37/67) 52,63% (20/38) 16,12% (15/93) 0,000 TAG criteria 22,38% (15/67) 28,94% (11/38) 22,58% (21/93) 0,703 Glycemia criteria 7,69% (4/52) 13,15% (5/38) 25,67% (19/74) 0,114 Metabolic Syndrome 24,35% (19/78) 25% (9/36) 22,44% (22/98) 0,934 Regarding inflammatory biomarkers, there was a significant difference between biomarkers elevated in each disease: hsCRP was found more frequently in RA, E-Selectin in SSc and VCAM and PAI-1 were more prevalent in SLE. Conclusion: We found a similar frequency of metabolic syndrome in our cohorts of RA, SSc and SLE Paraguayan patients but they had a different clinical and serological profile, suggesting that the pathways leading to metabolic syndrome are dissimilar in each disease. We need more studies to confirm this hypothesis. Disclosure of Interests: None declared