BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory disease. Excess cardiovascular risks were well recognized in patients with AS and were attributed to prolonged systemic inflammation. Uveitis is one of the most common extra-articular symptoms of AS and is also considered an indicator of systemic inflammation. This study aimed to investigate whether uveitis was a risk factor for developing acute myocardial infarction (AMI) in patients with AS using the National Health Insurance Research Database (NHIRD).MethodsData were collected from the NHIRD over a fifteen-year period. Variables were analyzed using the Pearson chi-square test and Fisher’s exact test. Risk factors for the occurrence of AMI were examined by calculating hazard ratio. Kaplan-Meier analysis was performed to compare the cumulative incidence of AMI in the uveitis and non-uveitis cohorts.ResultsA total of 5905 patients with AS were enrolled, including 1181 patients with uveitis (20%) and 4724 patients without uveitis (80%). The Kaplan–Meier method with the log-rank test showed that the uveitis group had a significantly higher cumulative hazard for patients with AMI than the non-uveitis group (p < 0.001). The adjusted hazard ratio (aHR) of AMI was higher in the uveitis group than in the non-uveitis group (aHR = 1.653, p < 0.001). Stratified analysis revealed that patients with uveitis had an increased risk of developing AMI regardless of their sex (male/female aHR = 1.688/1.608, p < 0.001). Patients with uveitis in all age groups were independently associated with an increased risk of developing AMI compared to those without uveitis (20–39 years/40–59 years/≥ 60 years, aHR = 1.550, 1.579, 3.240, p < 0.001). Patients with uveitis had a higher probability of developing AMI regardless of comorbidities. Uveitis patients with comorbidities had a higher risk of developing AMI compared to uveitis patients without comorbidities.ConclusionUveitis is a significant risk factor for developing AMI in patients with AS. Physicians should be aware of the potential cardiovascular risk in AS patients with uveitis, especially simultaneously with other traditional risk factors of AMI. Further prospective studies are needed to elucidate the underlying mechanism between uveitis and AMI in patients with AS.

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The homeostatic model assessment of insulin resistance (HOMA-IR) was used to measure the degree of insulin resistance (IR). Previous literature revealed that mid-arm muscle circumference (MAMC) is one of the anthropometric indicators for nutritional status and the relationship between MAMC and HOMA-IR remains uncertain in the obese and non-obese elderly individuals. The present study included 5,607 participants aged between 60 to 84 years old, using data from the 1999 to 2006 National Health and Nutrition Examination Survey (NHANES). To further explore the association between HOMA-IR and MAMC in the obese and non-obese elderly population using multivariate Cox regression analyses, we divided the participants into obese (BMI ≥ 30 kg/m2) group and non-obese (19 ≤ BMI < 30 kg/m2) group in this study; each group was then divided into quartiles based on their MAMC levels. A positive association was noted between the MAMC and HOMA-IR in all of the designed models initially. After adjusting for multiple covariates, a higher level of the MAMC was significantly associated with elevated HOMA-IR (P < 0.05) in the non-obesity group, which was not the case in the obesity group. Additionally, subjects in the higher quartiles of MAMC tended to have higher HOMA-IR with a significant association (P for trend = 0.003 in model 1; P for trend < 0.001 in model 2, 3, and 4). These results demonstrated that the MAMC can be an auxiliary indicator of HOMA-IR in non-obese elderly individuals and may have substantial additional value in screening for IR if well extrapolated.