Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Abstract

on behalf of CATCH investigatorsObjective. Metabolic syndrome (MetS) prevalence in early rheumatoid arthritis (ERA) is conflicting. The impact of sex, including menopause, has not been described. We estimated the prevalence and factors associated with MetS in men and women with ERA.Methods. A cross-sectional study of the Canadian Early Arthritis Cohort (CATCH) was performed. Participants with baseline data to estimate key MetS components were included. Sex-stratified logistic regression identified baseline variables associated with MetS.Results. The sample included 1543 participants; 71% were female and the mean age was 54 (SD 15) years. MetS prevalence was higher in men 188 (42%) than women 288 (26%, P < 0.0001) and increased with age. Frequent MetS components in men were hypertension (62%), impaired glucose tolerance (IGT, 40%), obesity (36%), and low high-density lipoprotein cholesterol (36%). Postmenopausal women had greater frequency of hypertension (65%), IGT (32%), and high triglycerides (21%) compared with premenopausal women (P < 0.001). In multivariate analysis, MetS was negatively associated with seropositivity and pulmonary disease in men. Increasing age was associated with MetS in women. In postmenopausal women, corticosteroid use was associated with MetS. Psychiatric comorbidity was associated with MetS in premenopausal women. MetS status was not explained by disease activity or core RA measures.Conclusion. The characteristics and associations of MetS differed in men and women with ERA. Sex differences, including postmenopausal status, should be considered in comorbidity screening. With this knowledge, the interplay of MetS, sex, and RA therapeutic response on cardiovascular outcomes should be investigated.

Prevalence of Metabolic Syndrome in Patients With Rheumatoid Arthritis: An Updated Systematic Review and Meta-Analysis

“…Inflammatory cytokines such as TNFα also reduce insulin function and facilitate insulin resistance (2). On the other hand, these patients use non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids to control the disease, which can cause metabolic disorders such as high blood pressure, obesity and diabetes (27). Serum levels of some biomarkers associated with metabolic syndrome, adipokines such as adiponectin, and biomarkers of endothelial cell activation and inflammation may appear to be useful in predicting cardiovascular risk in patients with RA (72).…”

“…The prevalence of metabolic syndrome increased significantly with age (in studies in the Americas). The prevalence of metabolic syndrome in the general population also increases with age (27), which can be due to redistribution of adipose tissue, weight gain, insulin resistance, and lipid changes (75).…”

Gout, Rheumatoid Arthritis, and the Risk of Death Related to Coronavirus Disease 2019: An Analysis of the UK Biobank

“…In contrast, RA was associated with increased risk of death from COVID-19 in both models (model 1: OR 3.2 [95% CI 2.1-5.0]; model 2: OR 1.9 [95% CI 1.2-3.0]). Given the association of sex with prevalence of comorbidity in gout and RA (20)(21)(22)(23), sex-specific analyses were performed. In RA, the data were OR 2.9 (95% CI 1.5-5.7) for men and OR 3.5 (95% CI 1.9-6.4) for women in model 1 and OR 1.5 (95% CI 0.7-3.1) for men and OR 2.0 (95% CI 1.0-3.7) for women in model 2.…”

Circulating Pro- and Anti-Inflammatory Metabolites and Its Potential Role in Rheumatoid Arthritis Pathogenesis

“…RA patients present several comorbidities including obesity, metabolic syndrome, and sarcopenia, probably triggered by a disbalance of proinflammatory cytokines including TNF and IL-6 among other causes [73][74][75][76][77], that will modify the circulating metabolites [78]. Several studies have investigated circulating metabolic changes related to the metabolic syndrome and obesity [79,80].…”