Background:
Metabolic syndrome (MetS) is characterized by insulin resistance, high blood pressure/sugar, dyslipidemia, and obesity. Whether MetS and its components affect the development of Behçet's Disease (BD) remains unclear.
Aims:
The aim was to determine the frequency of MetS among BD patients and to study its relation to the disease characteristics.
Methods:
The study included 1028 adult BD patients recruited from 18 specialized rheumatology centers. 51 healthy matched control were considered. Behçet Disease Current Activity Form (BDCAF) and the BD damage index (BDI) were estimated. Adult Treatment Panel-III criteria were used to define MetS.
Results:
The mean age of patients was 36.8±10.1 years, M:F 2.7:1 and disease duration 7.01±5.2 years. Their mean BDCAF was 5.1±4.6 and BDI 5.5±2.8. MetS was present in 22.8% of patients and in 5.9% of control (3.9 fold higher-risk). Patients with MetS had a significantly increased age at onset (31.8±9.2 vs 29±8.5 years) and higher frequency of genital ulcers (96.2% vs 79.7%), skin involvement (73.1% vs 50.4%), arthritis (48.3% vs 29.1%)(p<0.0001) and CNS manifestations (18.8% vs 13%)(p=0.042) compared to those without. Eye involvement was significantly increased in those with MetS (82.1% vs 74.2%)(p=0.003) with increased frequency of posterior uveitis (67.1% vs 43.5%), retinal vessel occlusion (35.9% vs 21.3%), retinal vasculitis (41.9% vs 26.4%)(p<0.0001) and vitritis (37.2% vs 24%)(p=0.001). BDCAF was significantly lower (3.9±4.3 vs 5.6±4.6) and BDI higher (7.4±2.7vs5±2.6)(p<0.0001).
Conclusion:
BD patients with MetS are predisposed to mucocutaneous, musculoskeletal, neuropsychiatric and ocular manifestations with consequently increased damage. The affection of the deeper structures of the eye should alarm rheumatologists to keep in mind that all patients should have an eye examination especially those with MetS.
To depict the spectrum of rheumatoid arthritis (RA) in Egypt in relation to other universal studies to provide broad-based characteristics to this particular population. This work included 10,364 adult RA patients from 26 specialized Egyptian rheumatology centers representing 22 major cities all over the country. The demographic and clinical features as well as therapeutic data were assessed. The mean age of the patients was 44.8 ± 11.7 years, disease duration 6.4 ± 6 years, and age at onset 38.4 ± 11.6 years; 209 (2%) were juvenile-onset. They were 8750 females and 1614 males (F:M 5.4:1). 8% were diabetic and 11.5% hypertensive. Their disease activity score (DAS28) was 4.4 ± 1.4 and health assessment questionnaire (HAQ) 0.95 ± 0.64. The rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) were positive in 73.7% and 66.7% respectively. Methotrexate was the most used treatment (78%) followed by hydroxychloroquine (73.7%) and steroids (71.3%). Biologic therapy was received by 11.6% with a significantly higher frequency by males vs females (15.7% vs 10.9%, p = 0.001). The least age at onset, F:M, RF and anti-CCP positivity were present in Upper Egypt (p < 0.0001), while the highest DAS28 was reported in Canal cities and Sinai (p < 0.0001). The HAQ was significantly increased in Upper Egypt with the least disability in Canal cities and Sinai (p = 0.001). Biologic therapy intake was higher in Lower Egypt followed by the Capital (p < 0.0001). The spectrum of RA phenotype in Egypt is variable across the country with an increasing shift in the F:M ratio. The age at onset was lower than in other countries.
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