POS1366 PREVALENCE OF METABOLIC SYNDROME IN INFLAMMATORY ARTHRITIS
Authors: K. Rogers, J. Southworth, R. M. Hum, P. Ho, S. S. Zhao
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> The global obesity epidemic presents a major challenge to chronic disease management. Obesity is a core component of metabolic syndrome and related comorbidities. Although studies have described the prevalence of metabolic syndrome in individual inflammatory arthritides, few have compared their prevalence in parallel. <h3>Objectives:</h3> To describe the prevalence of metabolic syndrome in rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS). <h3>Methods:</h3> This was an observational cross-sectional study using data from the UK Biobank, which is a study of over 500,000 adults between the ages of 40 and 69 who were recruited between 2006 and 2010. The participants with RA, PsA and AS were identified using ICD 10 codes from hospital admission data and Read codes from primary care, as well as by self-report. Metabolic syndrome was defined as per the widely adopted National Cholesterol Education Programme (NCEP) Adult Treatment Panel III (ATP III) criteria, which necessitates the fulfilment of at least three out of five specified criteria for diagnosis. These include: 1) Blood pressure &gt;130/85 (we utilised baseline blood pressure measurements, a self-reported or coded diagnosis of hypertension, or the use of antihypertensives). 2) Fasting blood sugar ≥ 5.6 mmol/l (we utilised baseline blood glucose measurements, a self-reported or coded diagnosis of Type 2 Diabetes Mellitus, or the use of diabetes medications (excluding insulin). 3) Waist circumference ≥ 102 cm in men or 88 cm in women. 4) High-density lipoprotein (HDL) cholesterol &lt;1 mmol/l in men or 1.293 mmol/l in women or use of a lipid-lowering medication. 5) Triglyceride levels ≥ 1.693 mmol/l (we utilised baseline blood triglyceride levels). <h3>Results:</h3> The study included a total of 502,422 participants with a mean (SD) age of 57 (8.1) years; comprising 229,088 (45.6%) males and 273,334 (54.4%) females. Among them, 3220 (0.6%) had Rheumatoid arthritis (RA), 1067 (0.2%) had Psoriatic Arthritis (PsA), 1483 (0.3%) had Ankylosing Spondylitis (AS) and the remaining 496652 (98.9%) without the three in inflammatory arthritides served as controls. Participants with RA, PsA and AS exhibited a higher prevalence of metabolic syndrome compared to the control group. Specifically, 1342 (41.7%) of those with RA, 432 (40.5%) with PsA, and 535 (36.1%) with AS had metabolic syndrome, compared to 152380 (30.7%) in the control group. Individuals in the RA, PsA and AS groups consistently exceeded controls in the proportions meeting each of the five metabolic syndrome criteria. Notably, RA group consistently surpassed the PsA and AS except for the triglyceride criterion. The most substantial disparity was observed in the proportions of individuals meeting the low HDL cholesterol criteria; 1385 (44.5%) in RA, 378 (37.7%) in PsA, 521 (37.8%) in AS, versus 147490 (31.4%) in the control group. Additionally, a significant difference was noted in the proportions of participants attaining the high glucose criteria: 702 (21.8%) in RA, 205 (19.2%) in PsA, 248 (16.7%) in AS, versus 75754 (15.3%) in the control group. On top of this, a much larger proportion of participants in the RA and PsA groups were on antihypertensive medication; 1206 (68.8%) in RA and 329 (47.1%) in PsA versus 448 (41.0%) in AS and 109417 (38.8%) in the control group. In a similar way, those with the inflammatory arthritides under investigation were more likely to have a previous diagnosis of hypertension: 1240 (38.7%) in RA, 399 (37.5%) in PsA, 520 (35.2%) in AS compared to 136744 (27.7%) in the control group. <h3>Conclusion:</h3> The findings of this cross-sectional study show that metabolic syndrome is highly prevalent even among individuals of the UK Biobank who are recognised to be healthier than the general population. Metabolic syndrome was more prevalent among people with RA, PsA and AS compared to those without these inflammatory arth<i>r</i>itides, with RA having the highest prevalence, then PsA and AS. These results highlight the importance of identifying and managing metabolic syndrome among people with inflammatory arthritis. <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> Kira Rogers: None declared, Joshua Southworth: None declared, Ryan Malcolm Hum: None declared, Pauline Ho Abbvie, Novartis, Janssen, Sizheng Steven Zhao UCB, Novartis, UCB