Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis

被引:250
作者
Chung, Cecilia P. [1 ]
Oeser, Annette [1 ]
Solus, Joseph F. [1 ]
Avalos, Ingrid [1 ]
Gebretsadik, Tebeb [2 ]
Shintani, Ayurni [2 ]
Raggi, Paolo [3 ]
Sokka, Tuulikki [1 ,4 ]
Pincus, Theodore [1 ]
Stein, C. Michael [1 ]
机构
[1] Vanderbilt Univ, Div Clin Pharmacol, Sch Med, Dept Med, Nashville, TN 37232 USA
[2] Vanderbilt Univ, Dept Biostat, Sch Med, Nashville, TN 37232 USA
[3] Emory Univ, Sch Med, Div Cardiol, Atlanta, GA 30322 USA
[4] Jyvaskyla Cent Hosp, Jyvaskyla, Finland
基金
美国国家卫生研究院;
关键词
atherosclerosis; rheumatoid arthritis; metabolic syndrome; insulin; coronary-artery calcification;
D O I
10.1016/j.atherosclerosis.2007.01.004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients with rheumatoid arthritis (RA) have accelerated atherosclerosis. The metabolic syndrome, a cluster of cardiovascular risk factors, identifies cardiovascular risk. We tested the hypotheses that patients with RA have a higher prevalence of the metabolic syndrome, particularly the WHO-defined syndrome that requires insulin resistance, and that this is associated with coronary atherosclerosis. The prevalence of the metabolic syndrome was determined using the modified WHO and NCEP III criteria in 154 patients with RA (88 with early RA and 66 with long-standing RA) and 85 control subjects. Coronary-artery atherosclerosis was detected by electron beam computed tomography. The WHO-defined metabolic syndrome was present in 42% of patients with long-standing RA, 31% with early RA and 11% of controls (P < 0.001); the NCEP-defined metabolic syndrome was present in 42% of patients with long-standing RA, 30% with early RA and 22% of controls (P=0.03). Patients with the WHO-defined metabolic syndrome had an increased risk of having higher coronary-artery calcification scores, independent of age and sex (OR=2.02, 95% CI: 1.03 - 3.97, P=0.04). In conclusion, patients with RA have a higher prevalence of the metabolic syndrome than control subjects. Inflammation-associated metabolic syndrome is a mechanism that may contribute to increased coronary-artery atherosclerosis in RA. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:756 / 763
页数:8
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