Prevalence and factors associated with metabolic syndrome in patients with rheumatoid arthritis and systemic lupus erythematosus

Purpose: To assess the frequency and factors associated with metabolic syndrome in adult female patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods: During January and June 2006, 192 consecutive adult female patients seen during their scheduled appointment at the out-patient rheumatology clinic and meeting the American College of Rheumatology classification criteria for RA and SLE were invited to participate in this study. Sociodemographic, menopausal status, personal history of coronary heart disease, and physical activity were evaluated. According to the National Cholesterol Education Program Adult Treatment III (NCEP/ATP III), metabolic syndrome was defined as >= 3 of the following criteria: increased waist circumference (>88 cm or 35 inches), hypertriglyceridemia (>= 150 mg/ dL), low (<40 mg/dL) high-density lipoprotein, hypertension, and high fasting glucose (>= 110 mg/dL). Results: One hundred-seyen RA and 85 SLE patients with a mean age of 43 +/- 13 years were included in this study. The frequency of obesity and abnormal waist circumference were similar in RA and SLE patients. Two percent were under-weight, 35% had a normal weight, 37% were overweight, and 25% were obese. The frequency of metabolic syndrome in RA and SLE patients was 17%. Metabolic syndrome was significantly associated with greater age, less education, lower income, and smoking. In RA patients, metabolic syndrome was significantly associated with a shorter treatment period with methotrexate, with pain, and with health assessment questionnaire scores. By multivariate logistic regression, the only statistically significant predictor of metabolic syndrome was smoking. Conclusions: The frequency of metabolic syndrome in RA and SLE patients was similar and associated with smoking. In RA patients, metabolic syndrome was related with pain and functional status, suggesting disease activity. A better control of disease activity may reduce the presence of metabolic syndrome and the risk of cardiovascular disease.