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Is the frequency of metabolic syndrome higher in South Korean women with rheumatoid arthritis than in healthy subjects?

  • Lee, Seung-Geun (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Ji-Min (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Lee, Sun-Hee (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Kye-Hyung (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Kim, Ji-Hye (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Yi, Ji-Won (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Jung, Woo-Jin (Department of Internal Medicine, Pusan National University School of Medicine) ;
  • Park, Young-Eun (Department of Internal Medicine, Malgeunsem Hospital) ;
  • Park, Seong-Hu (Department of Internal Medicine, Young Do Hospital) ;
  • Lee, Joung-Wook (Department of Internal Medicine, Busan St. Mary's Medical Center) ;
  • Baek, Seung-Hoon (Department of Internal Medicine, Ilsin Christian Hospital) ;
  • Lee, Jun-Hee (Department of Internal Medicine, Ilsin Christian Hospital) ;
  • Kim, Geun-Tae (Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine)
  • Published : 2013.03.01

Abstract

Background/Aims: To compare the frequency of metabolic syndrome (MetS) and magnitude of insulin resistance, measured by the homeostatic model assessment of insulin resistance (HOMA-IR), between South Korean women with rheumatoid arthritis (RA) and healthy subjects, and to evaluate risk factors for MetS and increased HOMA-IR in patients with RA. Methods: In a cross-sectional setting, 84 female patients with RA and 109 agematched healthy female subjects were consecutively recruited at a university-affiliated rheumatology center in South Korea. MetS was defined according to the Third Report of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP III) 2004 criteria. Results: The frequency of MetS did not differ significantly between patients with RA (19%) and healthy subjects (15.6%, p = 0.566), although patients with RA had a higher HOMA-IR compared with healthy subjects (p < 0.001). Patients with RA met the NCEP-ATP III 2004 criteria for high blood pressure more often than healthy subjects (44% vs. 19.3%, p < 0.001), and low high density lipoprotein cholesterol was more prevalent in healthy subjects (33%) than in patients with RA (14.3%, p = 0.004). Although no obvious risk factors for the presence of MetS were identified in patients with RA, higher serum C-reactive protein and disease activity score assessed using the 28-joint count for swelling and tenderness-erythrocyte sedimentation rate significantly contributed to a higher HOMA-IR. Conclusions: Despite their increased insulin resistance, South Korean women with RA did not have a significantly higher frequency of MetS compared with that in healthy subjects.

Keywords

References

  1. Dandona P, Aljada A, Chaudhuri A, Mohanty P, Garg R. Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005;111:1448-1454. https://doi.org/10.1161/01.CIR.0000158483.13093.9D
  2. Hanley AJ, Williams K, Stern MP, Haffner SM. Homeostasis model assessment of insulin resistance in relation to the incidence of cardiovascular disease: the San Antonio Heart Study. Diabetes Care 2002;25:1177-1184. https://doi.org/10.2337/diacare.25.7.1177
  3. Reilly MP, Wolfe ML, Rhodes T, Girman C, Mehta N, Rader DJ. Measures of insulin resistance add incremental value to the clinical diagnosis of metabolic syndrome in association with coronary atherosclerosis. Circulation 2004;110:803-809. https://doi.org/10.1161/01.CIR.0000138740.84883.9C
  4. Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol 2010;56:1113-1132. https://doi.org/10.1016/j.jacc.2010.05.034
  5. Pereira RM, de Carvalho JF, Bonfa E. Metabolic syndrome in rheumatological diseases. Autoimmun Rev 2009;8:415-419. https://doi.org/10.1016/j.autrev.2009.01.001
  6. Santos MJ, Fonseca JE. Metabolic syndrome, inflammation and atherosclerosis: the role of adipokines in health and in systemic inflammatory rheumatic diseases. Acta Reumatol Port 2009;34:590-598.
  7. Sidiropoulos PI, Karvounaris SA, Boumpas DT. Metabolic syndrome in rheumatic diseases: epidemiology, pathophysiology, and clinical implications. Arthritis Res Ther 2008;10:207. https://doi.org/10.1186/ar2397
  8. Nakanishi N, Shiraishi T, Wada M. Association between C-reactive protein and insulin resistance in a Japanese population: the Minoh Study. Intern Med 2005;44:542-547. https://doi.org/10.2169/internalmedicine.44.542
  9. Ozbalkan Z, Efe C, Cesur M, et al. An update on the relationships between rheumatoid arthritis and atherosclerosis. Atherosclerosis 2010;212:377-382. https://doi.org/10.1016/j.atherosclerosis.2010.03.035
  10. Gremese E, Ferraccioli G. The metabolic syndrome: the crossroads between rheumatoid arthritis and cardiovascular risk. Autoimmun Rev 2011;10:582-589. https://doi.org/10.1016/j.autrev.2011.04.018
  11. Dessein PH, Tobias M, Veller MG. Metabolic syndrome and subclinical atherosclerosis in rheumatoid arthritis. J Rheumatol 2006;33:2425-2432.
  12. Karvounaris SA, Sidiropoulos PI, Papadakis JA, et al. Metabolic syndrome is common among middle-toolder aged Mediterranean patients with rheumatoid arthritis and correlates with disease activity: a retrospective, cross-sectional, controlled, study. Ann Rheum Dis 2007;66:28-33.
  13. La Montagna G, Cacciapuoti F, Buono R, et al. Insulin resistance is an independent risk factor for atherosclerosis in rheumatoid arthritis. Diab Vasc Dis Res 2007;4:130-135. https://doi.org/10.3132/dvdr.2007.031
  14. Chung CP, Oeser A, Solus JF, et al. Prevalence of the metabolic syndrome is increased in rheumatoid arthritis and is associated with coronary atherosclerosis. Atherosclerosis 2008;196:756-763. https://doi.org/10.1016/j.atherosclerosis.2007.01.004
  15. Toms TE, Panoulas VF, Douglas KM, Griff iths HR, Kitas GD. Lack of association between glucocorticoid use and presence of the metabolic syndrome in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2008;10:R145. https://doi.org/10.1186/ar2578
  16. Zonana-Nacach A, Santana-Sahagun E, Jimenez-Balderas FJ, Camargo-Coronel A. Prevalence and factors associated with metabolic syndrome in patients with rheumatoid arthritis and systemic lupus erythematosus. J Clin Rheumatol 2008;14:74-77. https://doi.org/10.1097/RHU.0b013e31816b2faa
  17. Elkan AC, Hakansson N, Frostegard J, Cederholm T, Hafstrom I. Rheumatoid cachexia is associated with dyslipidemia and low levels of atheroprotective natural antibodies against phosphorylcholine but not with dietary fat in patients with rheumatoid arthritis: a crosssectional study. Arthritis Res Ther 2009;11:R37. https://doi.org/10.1186/ar2643
  18. Toms TE, Panoulas VF, John H, Douglas KM, Kitas GD. Methotrexate therapy associates with reduced prevalence of the metabolic syndrome in rheumatoid arthritis patients over the age of 60- more than just an antiinflammatory effect? A cross sectional study. Arthritis Res Ther 2009;11:R110. https://doi.org/10.1186/ar2765
  19. Dao HH, Do QT, Sakamoto J. Increased frequency of metabolic syndrome among Vietnamese women with early rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2010;12:R218. https://doi.org/10.1186/ar3203
  20. Raterman HG, van Eijk IC, Voskuyl AE, et al. The metabolic syndrome is amplified in hypothyroid rheumatoid arthritis patients: a cross-sectional study. Ann Rheum Dis 2010;69:39-42. https://doi.org/10.1136/ard.2008.100776
  21. Crowson CS, Myasoedova E, Davis JM 3rd, et al. Increased prevalence of metabolic syndrome associated with rheumatoid arthritis in patients without clinical cardiovascular disease. J Rheumatol 2011;38:29-35. https://doi.org/10.3899/jrheum.100346
  22. Mok CC, Ko GT, Ho LY, Yu KL, Chan PT, To CH. Prevalence of atherosclerotic risk factors and the metabolic syndrome in patients with chronic inf lammatory arthritis. Arthritis Care Res (Hoboken) 2011;63:195-202. https://doi.org/10.1002/acr.20363
  23. Sahebari M, Goshayeshi L, Mirfeizi Z, et al. Investigation of the association between metabolic syndrome and disease activity in rheumatoid arthritis. Scientif icWorldJournal 2011;11:1195-1205. https://doi.org/10.1100/tsw.2011.111
  24. Karimi M, Mazloomzadeh S, Kafan S, Amirmoghadami H. The frequency of metabolic syndrome in women with rheumatoid arthritis and in controls. Int J Rheum Dis 2011;14:248-254. https://doi.org/10.1111/j.1756-185X.2011.01595.x
  25. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988;31:315-324. https://doi.org/10.1002/art.1780310302
  26. Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995;38:44-48. https://doi.org/10.1002/art.1780380107
  27. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-2752. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  28. Heng D, Ma S, Lee JJ, et al. Modification of the NCEP ATP III definitions of the metabolic syndrome for use in Asians identifies individuals at risk of ischemic heart disease. Atherosclerosis 2006;186:367-373. https://doi.org/10.1016/j.atherosclerosis.2005.07.020
  29. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419. https://doi.org/10.1007/BF00280883
  30. Yiu KH, Tse HF, Mok MY, Lau CS. Ethnic differences in cardiovascular risk in rheumatic disease: focus on Asians. Nat Rev Rheumatol 2011;7:609-618. https://doi.org/10.1038/nrrheum.2011.126
  31. Raterman HG, Voskuyl AE, Dijkmans BA, Nurmohamed MT. Use of methotrexate therapy is not associated with decreased prevalence of metabolic syndrome. Arthritis Res Ther 2009;11:413. https://doi.org/10.1186/ar2805
  32. Maxwell SR, Moots RJ, Kendall MJ. Corticosteroids: do they damage the cardiovascular system? Postgrad Med J 1994;70:863-870. https://doi.org/10.1136/pgmj.70.830.863
  33. Gonzalez-Gay MA. Glucocorticoid-related cardiovascular and cerebrovascular events in rheumatic diseases: myth or reality? Arthritis Rheum 2007;57:191-192. https://doi.org/10.1002/art.22546
  34. Hoes JN, Jacobs JW, Buttgereit F, Bijlsma JW. Current view of glucocorticoid co-therapy with DMARDs in rheumatoid arthritis. Nat Rev Rheumatol 2010;6:693-702. https://doi.org/10.1038/nrrheum.2010.179
  35. Singh B, Saxena A. Surrogate markers of insulin resistance: a review. World J Diabetes 2010;1:36-47. https://doi.org/10.4239/wjd.v1.i2.36
  36. Dessein PH, Joffe BI. Insulin resistance and impaired beta cell function in rheumatoid arthritis. Arthritis Rheum 2006;54:2765-2775. https://doi.org/10.1002/art.22053
  37. Chung CP, Oeser A, Solus JF, et al. Inflammation-associated insulin resistance: differential effects in rheumatoid arthritis and systemic lupus erythematosus define potential mechanisms. Arthritis Rheum 2008;58:2105-2112. https://doi.org/10.1002/art.23600
  38. Shahin D, Eltoraby E, Mesbah A, Houssen M. Insulin resistance in early untreated rheumatoid arthritis patients. Clin Biochem 2010;43:661-665. https://doi.org/10.1016/j.clinbiochem.2010.01.012
  39. Wasko MC, Kay J, Hsia EC, Rahman MU. Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: risk reduction in a chronic inflammatory disease. Arthritis Care Res (Hoboken) 2011;63:512-521. https://doi.org/10.1002/acr.20414
  40. Kendall DM, Harmel AP. The metabolic syndrome, type 2 diabetes, and cardiovascular disease: understanding the role of insulin resistance. Am J Manag Care 2002;8(20 Suppl):S635-S653.
  41. Balkau B, Charles MA. Comment on the provisional report from the WHO consultation: European Group for the Study of Insulin Resistance (EGIR). Diabet Med 1999;16:442-443. https://doi.org/10.1046/j.1464-5491.1999.00059.x
  42. Panoulas VF, Metsios GS, Pace AV, et al. Hypertension in rheumatoid arthritis. Rheumatology (Oxford) 2008;47:1286-1298. https://doi.org/10.1093/rheumatology/ken159
  43. Boers M, Nurmohamed MT, Doelman CJ, et al. Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis. Ann Rheum Dis 2003;62:842-845. https://doi.org/10.1136/ard.62.9.842
  44. Kang YH, Min HG, Kim IJ, Kim YK, Son SM. Comparison of alanine aminotransferase, white blood cell count, and uric acid in their association with metabolic syndrome: a study of Korean adults. Endocr J 2008;55:1093-1102. https://doi.org/10.1507/endocrj.K08E-077
  45. Choi SH, Ahn CW, Cha BS, et al. The prevalence of the metabolic syndrome in Korean adults: comparison of WHO and NCEP criteria. Yonsei Med J 2005;46:198-205. https://doi.org/10.3349/ymj.2005.46.2.198

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