Prevalence of Metabolic Syndrome in Rheumatoid Arthritis and to Assess its Effect on Disease Activity of Rheumatoid Arthritis

Abstract

Background: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease associated with increased cardiovascular morbidity and mortality. Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors. Chronic inflammation in RA may predispose to MetS, which in turn may worsen disease activity. Data from Central India is limited.Aims and Objectives: To determine the prevalence of metabolic syndrome in patients with rheumatoid arthritis and to assess its effect on disease activity.

Materials and Methods: This was a cross-sectional observational study conducted in the Department of Medicine. A total of 90 patients diagnosed with RA as per ACR/EULAR 2010 criteria were included. Detailed clinical history, anthropometry (BMI, waist circumference), blood pressure, and laboratory investigations including fasting blood sugar, lipid profile, ESR, CRP, Rheumatoid factor and Anti-CCP were done. Metabolic syndrome was diagnosed as per NCEP ATP III criteria (presence of ≥3 of 5 criteria). Disease activity was assessed by DAS28-ESR score. Patients were divided into two groups: RA with MetS and RA without MetS, and disease activity was compared.

Results: Out of 90 RA patients, mean age was 46.2 ± 10.5 years with female predominance (78.9%). The prevalence of metabolic syndrome was found in 38 patients (42.2%). Among MetS components, most common was abdominal obesity (58.9%), followed by low HDL (52.2%), hypertension (44.4%), hypertriglyceridemia (38.9%) and impaired fasting glucose (31.1%). Mean DAS28-ESR was significantly higher in RA patients with MetS (5.12 ± 0.98) as compared to without MetS (4.31 ± 1.12) (p < 0.001). Patients with MetS had longer disease duration and higher ESR/CRP levels. On correlation, DAS28 showed positive correlation with waist circumference and triglycerides. Conclusion: Metabolic syndrome is highly prevalent (42.2%) in RA patients and is associated with higher disease activity. Routine screening for MetS in RA patients is essential for comprehensive management and to reduce cardiovascular risk.