Is the frequency of metabolic syndrome higher in South Korean women with rheumatoid arthritis than in healthy subjects?

Lee, Seung-Geun; Kim, Ji Min; Lee, Sun Hee; Kim, Kye-Hyung; Kim, Ji Hye; Yi, Juyeon; Jung, Woo Jin; Park, Young Eun; Park, Seong Hu; Lee, Joung Wook; Baek, Seung Hoon; Lee, Jun Hee; Kim, Geun Tae

doi:10.3904/kjim.2013.28.2.206

Cited by 17 publications

(15 citation statements)

References 42 publications

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“…Another three studies were excluded for having incomplete data [22-24]. Twelve studies remained for inclusion in our meta-analysis [25-36]. A flow chart showing the study selection process is presented in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

The Risk of Metabolic Syndrome in Patients with Rheumatoid Arthritis: A Meta-Analysis of Observational Studies

Zhang

Shi

et al. 2013

PLoS ONE

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BackgroundObservational studies suggest an association between the incidence of rheumatoid arthritis (RA) and the prevalence of metabolic syndrome (MetS). However, the relationship between RA and MetS is controversial and research in this area is currently lacking.ObjectiveThe aim of this study was to assess whether the prevalence of MetS was higher in a group of RA patients compared to subjects without RA.DesignA PubMed database search was conducted during April 2013 to identify observational studies of RA and risk of MetS. Reference lists of retrieved articles were also reviewed. Two authors independently extracted information on the study design, the characteristics of the study participants, exposure and outcome assessments, and the method used to control for potential confounding factors. A random-effects model was used for the risk estimates.ResultsOur meta-analysis of four cross-sectional controlled studies plus eight case-control studies involving a total of 2283 cases and 4403 controls identified a significant association between RA and risk of MetS, with an overall OR of 1.24 (95% CI, 1.03-1.50).ConclusionThis meta-analysis provides further evidence supporting patients with RA have a higher prevalence of MetS than subjects without RA. In addition, the geographic region of the population and the criteria used for MetS diagnosis could influence the association. However, these observations would need to be evaluated using prospective, randomized studies.

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Section: Resultsmentioning

confidence: 99%

The Risk of Metabolic Syndrome in Patients with Rheumatoid Arthritis: A Meta-Analysis of Observational Studies

Zhang

Shi

et al. 2013

PLoS ONE

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“…Furthermore, Karvounaris et al found prevalence of MetS to be similar in RA patients (44%) to their control population (41%), but they also found a relationship between disease activity and the presence of MetS [32]. It is also worth mentioning that several studies have not reported any association between RA and MetS [33, 34]. …”

Section: Discussionmentioning

confidence: 99%

“…Rheumatoid arthritis and metabolic syndrome are considered to be diseases with common traits that can increase the risk of cardiovascular disease[11], with previous research showing an association between the two[12]. Higher frequencies of insulin resistance and MetS have been reported in patients with RA [12, 13], with the frequency of MetS in RA patients ranging from 14 to 56% [14]. This variation can be explained by differences in the definition of MetS, along with differences in ethnicity, geographic area, study design, and study population.…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome and its components among rheumatoid arthritis patients: A comprehensive updated systematic review and meta-analysis

et al. 2017

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BackgroundEstimating the current global prevalence of metabolic syndrome (MetS), and its components, among rheumatoid arthritis (RA) patients is necessary in order to formulate preventative strategies and to ensure there are adequate community resources available for these patients. Furthermore, the association between RA and MetS is controversial and has not previously been comprehensively assessed. Therefore, the present study aimed to: 1) determine the prevalence of MetS, and its components, among RA patients across the world 2) update the odds ratio of MetS in RA patients, compared to healthy controls, using a comprehensive systematic review and meta-analysis.MethodsInternational databases, including: the Web of Science, PubMed, Scopus, Embase, CINAHL and other relevant databases were searched to identify English language articles which reported the prevalence and risk of MetS in RA patients between January 2000 and August 2016. The meta-analysis only included studies which clearly described the time and location of the study, utilised adequate sampling strategies, and appropriate statistical analyses.ResultsThe meta-analyses of prevalence (70 studies [n = 12612]) and risk (43 studies [n = 35220]) of MetS in RA patients were undertaken separately. The overall pooled prevalence of MetS was 30.65% (95% CI: 27.87–33.43), but this varied from 14.32% (95% CI: 10.59–18.05) to 37.83% (95% CI: 31.05–44.61), based upon the diagnostic criteria used. The prevalence of MetS also varied slightly between males (31.94%, 95% CI: 24.37–39.51) and females (33.03%, 95% CI: 28.09–37.97), but this was not statistically significant. The overall pooled odds ratio (OR) of MetS in RA patients, compared to healthy controls, was 1.44 (95% CI: 1.20–1.74), but this ranged from 0.70 (95% CI: 0.27–1.76) to 4.09 (95% CI: 2.03–8.25), depending on the criteria used. The mean age and diagnostic criteria of MetS were identified as sources of heterogeneity in the estimated odds ratios between studies (P<0.05).ConclusionsAccording to the high prevalence of MetS in RA patients, and high risk of MetS, measuring metabolic syndrome in RA patients is strongly recommended. Furthermore, as high waist circumference (WC) is the most common metabolic syndrome component, more attention must be paid to nutrition and weight loss among those with RA.

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“…They had an atherogenic lipid profile characterized by an increase in total cholesterol, LDL-c, and triglycerides and a reduction in serum HDL-c levels. 43 Cytokines are crucial in trafficking mononuclear cells into synovium, leading to the initiation and progression of the disease. In one study of patients with established RA, total cholesterol was only slightly raised, irrespective of disease activity.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of methotrexate therapy with occasional corticosteroid in rheumatoid arthritis

Patel

Kumar

Mishra

et al. 2015

Current Orthopaedic Practice

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Background:Rheumatoid arthritis is an immunologically driven chronic synovitis showing heterogeneity in disease progression, treatment, and variability of response to therapy. This study investigated the effectiveness of methotrexate, folic acid, and vitamin C for treatment of patients with rheumatoid arthritis. Methods:The effects of methotrexate with folic acid, vitamin C, and an occasional steroid were analyzed in 62 patients with rheumatoid arthritis selected on the basis of American College of Rheumatology (ACR) criteria, before and after 24 wk of therapy on (1) lipoprotein profile, (2) Disease Activity Score (DAS)-28, Creactive protein (CRP) and erythrocyte sedimentation rate (ESR), and (3) oxidative stress. Results:After 24 wk of therapy, the response rates were ACR70 in 72% (45), ACR50 in 21% (13), and ACR20 in 7% (4). The median initial DAS-28-CRP of 5.2 was reduced to 2.5 and median VAS of 7.7 was reduced to 2.4. Assuming normality in the control data, the power of the analysis was 92%. The mean level of lowdensity lipoprotein-cholesterol (LDL-c), total cholesterol, malondialdehyde, CRP, and triglycerides were significantly (P < 0.05) higher, but blood pressure, uric acid, and creatinine were normal in RA patients at baseline. Significant improvements in level of high-density lipoprotein-cholesterol (HDL-c), total cholesterol, CRP, malondialdehyde, and triglycerides were observed in rheumatoid patients treated with methotrexate. At baseline, CRP positively correlated with total lipids (r ¼ 0.28, P < 0.05) and total cholesterol (r ¼ 0.64, P < 0.01). Total cholesterol was negatively correlated with HDL-c (r ¼ À 0.40, P < 0.01). The blood pressure and liver function tests were within normal range at 4 yr follow-up. Conclusions:Methotrexate combination therapy was effective in (1) reducing disease activity, (2) improving rest pain and morning stiffness, and (3) improving lipid profile due to suppression of inflammation. However, whether or not it is capable of lowering or eliminating cardiovascular disease risk requires further investigation as morbidity and mortality are higher in patients with rheumatoid arthritis compared to the general population.

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Is the frequency of metabolic syndrome higher in South Korean women with rheumatoid arthritis than in healthy subjects?

Cited by 17 publications

References 42 publications

The Risk of Metabolic Syndrome in Patients with Rheumatoid Arthritis: A Meta-Analysis of Observational Studies

The Risk of Metabolic Syndrome in Patients with Rheumatoid Arthritis: A Meta-Analysis of Observational Studies

Metabolic syndrome and its components among rheumatoid arthritis patients: A comprehensive updated systematic review and meta-analysis

Effectiveness of methotrexate therapy with occasional corticosteroid in rheumatoid arthritis

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