scholarly journals High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

2019 ◽  
Vol 59 (1) ◽  
Author(s):  
Maria Fernanda Brandão de Resende Guimarães ◽  
Carlos Ewerton Maia Rodrigues ◽  
Kirla Wagner Poti Gomes ◽  
Carla Jorge Machado ◽  
Claiton Viegas Brenol ◽  
...  

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

2019 ◽  
Vol 34 (1) ◽  
pp. 107-117
Author(s):  
V. O. Omelchenko ◽  
E. A. Letyagina ◽  
M. A. Korolev ◽  
T. I. Pospelova

Introduction. Cardiovascular complications are more often observed in patients with rheumatoid arthritis. Available cardiovascular risk scales were developed for general population and provide in sufficiently adequate assessment of the cardiovascular event likelihood. Studying the risk factors in rheumatoid arthritis patients is necessary for timely diagnosis and prevention.Objective: To analyze the incidence of atherosclerotic lesions in the brachiocephalic arteries in patients with rheumatoid arthritis and associations of this pathology with cardiovascular risk factors.Material and Methods. Two hundred and twelve Caucasian patients with rheumatoid arthritis (age of 58.0 years [48.3; 65.0]; Disease Activity Score-28 of 4.96 [3.86; 5.85]) were included in our study. Patients had American College of Rheumatology-defined rheumatoid arthritis (1987 classification criteria). The ratio of women to men was 5.8 to 1. General clinical examination of patients, the identification of traditional cardiovascular risk factors, and the determination of disease activity were performed. The atherosclerotic progression was assessed by ultrasonography with carotid intima-media thickness measurement and atherosclerotic plaque detection. All patients gave written informed consent before enrollment into the study.Results. Atherosclerotic plaques were found in 59 patients (27.8%), predominantly in older individuals (66.0 [59.0; 73.0] versus 55.0 years [42.0; 61.0], p<0.001) and in men (51.6 versus 23.8% in women, p=0.001). Atherosclerotic plaques were detected in 46.3% of smokers versus 23.4% of non-smokers (p=0.003). Atherosclerotic plaques were more frequently detected in patients with type 2 diabetes mellitus (58.3 versus 26.0%, p=0.036), arterial hypertension (41.7 versus 5.0%, p<0.001), angina pectoris (73.1 versus 21.5%, p<0.001), past history of acute cerebrovascular event (83.3 versus 25.9%, p=0.008), and the presence of post-infarction cardiosclerosis (100.0 versus 26.6%, p=0.03). No atherosclerotic plaques were found in 48 non-climacteric women. Except for the level of rheumatoid factor, all parameters of rheumatoid arthritis activity did not demonstrate statistically significant differences between groups with and without atherosclerotic plaques. The intima-media thickness mainly correlated with age (rs=0.633, p<0.001) and was not associated with rheumatoid arthritis activity. After the use of age- and sex-specific ultrasound criteria, the proportion of patients with intima-media thickening increased from 34.9 to 58.0% (p<0.001). Prevalence rates of most cardiovascular risk factors were associated with age and gender.Conclusion. The present study identified the differences between the incidence rates of traditional risk factors in patients with rheumatoid arthritis compared with the corresponding values in world studies and generated comparable results with REMARKA study confirming a significance of studying this question in the context of the Russian population. The results, obtained in this study, improve understanding of the structure of risk factors in patients with rheumatoid arthritis and may provide the basis for the algorithm of curation of patient with high cardiovascular risk.


2007 ◽  
Vol 8 (1) ◽  
pp. 98
Author(s):  
J.A. Papadakis ◽  
S.T. Karvounaris ◽  
G. Vrentzos ◽  
H.D. Kritikos ◽  
P.I. Sidiropoulos ◽  
...  

Arthritis ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-17 ◽  
Author(s):  
Juan Camilo Sarmiento-Monroy ◽  
Jenny Amaya-Amaya ◽  
Juan Sebastián Espinosa-Serna ◽  
Catalina Herrera-Díaz ◽  
Juan-Manuel Anaya ◽  
...  

Background. Cardiovascular disease (CVD) is the major predictor of poor prognosis in rheumatoid arthritis (RA) patients. There is an increasing interest to identify “nontraditional” risk factors for this condition. Latin Americans (LA) are considered as a minority subpopulation and ethnically different due to admixture characteristics. To date, there are no systematic reviews of the literature published in LA and the Caribbean about CVD in RA patients. Methods. The systematic literature review was done by two blinded reviewers who independently assessed studies for eligibility. The search was completed through PubMed, LILACS, SciELO, and Virtual Health Library scientific databases. Results. The search retrieved 10,083 potential studies. A total of 16 articles concerning cardiovascular risk factors and measurement of any cardiovascular outcome in LA were included. The prevalence of CVD in LA patients with RA was 35.3%. Non-traditional risk factors associated to CVD in this population were HLA-DRB1 shared epitope alleles, rheumatoid factor, markers of chronic inflammation, long duration of RA, steroids, familial autoimmunity, and thrombogenic factors. Conclusions. There is limited data about CVD and RA in LA. We propose to evaluate cardiovascular risk factors comprehensively in the Latin RA patient and to generate specific public health policies in order to diminish morbi-mortality rates.


2019 ◽  
Vol 34 (1) ◽  
pp. 107-117
Author(s):  
V. O. Omelchenko ◽  
E. A. Letyagina ◽  
M. A. Korolev ◽  
T. I. Pospelova

Introduction. Cardiovascular complications are more often observed in patients with rheumatoid arthritis. Available cardiovascular risk scales were developed for general population and provide in sufficiently adequate assessment of the cardiovascular event likelihood. Studying the risk factors in rheumatoid arthritis patients is necessary for timely diagnosis and prevention.Objective: To analyze the incidence of atherosclerotic lesions in the brachiocephalic arteries in patients with rheumatoid arthritis and associations of this pathology with cardiovascular risk factors.Material and Methods. Two hundred and twelve Caucasian patients with rheumatoid arthritis (age of 58.0 years [48.3; 65.0]; Disease Activity Score-28 of 4.96 [3.86; 5.85]) were included in our study. Patients had American College of Rheumatology-defined rheumatoid arthritis (1987 classification criteria). The ratio of women to men was 5.8 to 1. General clinical examination of patients, the identification of traditional cardiovascular risk factors, and the determination of disease activity were performed. The atherosclerotic progression was assessed by ultrasonography with carotid intima-media thickness measurement and atherosclerotic plaque detection. All patients gave written informed consent before enrollment into the study.Results. Atherosclerotic plaques were found in 59 patients (27.8%), predominantly in older individuals (66.0 [59.0; 73.0] versus 55.0 years [42.0; 61.0], p<0.001) and in men (51.6 versus 23.8% in women, p=0.001). Atherosclerotic plaques were detected in 46.3% of smokers versus 23.4% of non-smokers (p=0.003). Atherosclerotic plaques were more frequently detected in patients with type 2 diabetes mellitus (58.3 versus 26.0%, p=0.036), arterial hypertension (41.7 versus 5.0%, p<0.001), angina pectoris (73.1 versus 21.5%, p<0.001), past history of acute cerebrovascular event (83.3 versus 25.9%, p=0.008), and the presence of post-infarction cardiosclerosis (100.0 versus 26.6%, p=0.03). No atherosclerotic plaques were found in 48 non-climacteric women. Except for the level of rheumatoid factor, all parameters of rheumatoid arthritis activity did not demonstrate statistically significant differences between groups with and without atherosclerotic plaques. The intima-media thickness mainly correlated with age (rs=0.633, p<0.001) and was not associated with rheumatoid arthritis activity. After the use of age- and sex-specific ultrasound criteria, the proportion of patients with intima-media thickening increased from 34.9 to 58.0% (p<0.001). Prevalence rates of most cardiovascular risk factors were associated with age and gender.Conclusion. The present study identified the differences between the incidence rates of traditional risk factors in patients with rheumatoid arthritis compared with the corresponding values in world studies and generated comparable results with REMARKA study confirming a significance of studying this question in the context of the Russian population. The results, obtained in this study, improve understanding of the structure of risk factors in patients with rheumatoid arthritis and may provide the basis for the algorithm of curation of patient with high cardiovascular risk.


2009 ◽  
Vol 69 (3) ◽  
pp. 517-521 ◽  
Author(s):  
D Daoussis ◽  
V F Panoulas ◽  
I Antonopoulos ◽  
H John ◽  
T E Toms ◽  
...  

ObjectivesThe present study aimed to evaluate the prevalence and associations of renal dysfunction in patients with rheumatoid arthritis (RA). It specifically addressed the hypotheses that renal dysfunction in these patients may associate with the presence of insulin resistance, dyslipidaemia, uric acid levels and/or current levels of systemic inflammation.MethodsRenal function was assessed by estimated glomerular filtration rate (GFR) using the modification of diet in renal disease equation in 400 consecutive RA patients for this cross-sectional, single-centre study. Risk factors for renal dysfunction were recorded/measured in all participants. Correlations between GFR and other variables were analysed by Pearson or Spearman test as appropriate. Linear regression was used to test the independence of the associations between GFR and other variables.ResultsIn this RA patient cohort, 67.75% of patients had a reduced GFR of less than 90 ml/minute per 1.73 m2 and 12.75% had a GFR of less than 60 ml/minute per 1.73 m2. Multivariable analysis revealed significant associations between GFR and age (β = −0.370, p<0.001), female sex (β = −0.181, p=0.002), total cholesterol (β = −0.112, p=0.022), serum uric acid (SUA) (β = −0.425, p<0.001) and the presence of extra-articular disease, apart from sicca and/or nodules (β = −0.084, p=0.040).ConclusionsRenal dysfunction in RA is quite common and associates with classic cardiovascular risk factors such as advanced age and dyslipidaemia, levels of SUA and the presence of extra-articular disease. Renal dysfunction was not related to other RA-related factors including disease activity and duration, disability and past or present use of nephrotoxic medications.


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