SAT0260 Prevalence of Metabolic Syndrome in Patients with Ankylosing Spondylitis in Morocco: A Cross-Sectional Study of 103 Cases

Abstract

BackgroundMetabolic syndrome (MetS) is a metabolic disorder whose causes are: central obesity, hyperglycemia, dyslipidemia, and hypertension. In ankylosing spondylitis (AS), the prevalence of MetS appears to be high, suggesting that systemic inflammation and therapeutic used play a role in the development of MetS.ObjectivesThe aim of our study was to determine the prevalence of MS in AS, to identify factors associated with its presence, and to evaluate the influence of treatment used on its occurrence.MethodsThe prevalence of MetS was assessed cross-sectionally in 103 patients with AS fulfilling the modified New York criteria and collected in the Rheumatology Department of the University Hospital Hassan II of Fez. This study was conducted over a period of 18-months (September 2012- March 2014). The assessment of the prevalence of MS in these patients was established using the definition of NCEP/ATP III 2005 since it is the most commonly used in the literature.ResultsThe average age of patients was 38.62±13.330, with a male predominance (67%). 75% of patients are aged under 60 year-old. The median duration of the course of the disease was 7.11 years. The MetS is present in 34% of patients according to the definition used. It is associated with a Young-Onset disease (p=0.016), female gender (p=0.041), professional inactivity (p=0.015), disease activity assessed by ASDAS (p=0.039) and duration of disease progression (0.04)After multivariate logistic regression only female sex was identified as an independent predictor factor of MetS in patients with AS (OR=0,42; IC 95% [0,18-1,006]; p=0,041).ConclusionsOur findings showed a greater prevalence of MetS in AS female patients than in male patients. Age, disease activity, functional impact of the disease and the therapeutic use include NSAIDs did not appear to be related to the development of MetS in the population of patients studied. Further studies on a larger scale and covering a larger population with AS are needed to assess the association between chronic inflammation in AS and MetS, and to determine the effect of biological therapy in the development of the MetS.ReferencesDomenico Malesci, Alferio Niglio, Gianna Angela Mennillo & al. High prevalence of metabolic syndrome in patients with ankylosing spondylitis. Clin Rheumatol (2007) 26:710–714.Pehlevan S, Yetkin DO, Bahadır C, Goktay F, Pehlevan Y, Kayatas K, Ince N. Increased prevalence of metabolic syndrome in patients with psoriatic arthritis. Metab Syndr Relat Disord. 2014 Feb;12(1):43-8.Divecha H, Sattar N, Rumley A, Cherry L, Loe GD, Sturrock R(2005). Cardiovascular risk parameters in men with ankylosing spondylitis in comparison with non-inflammatory control subjects: relevance of systemic inflammation. Clin Sci (Lond)109:171–176.Han C, Robinson DW, Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 2006; 33: 2167-72.AcknowledgementsTo all membrs of the departement group of r...

Ankylosing Spondylitis Pathogenesis and Pathophysiology

“…There is growing recognition of the relationship between metabolic syndrome and ankylosing spondylitis [77][78][79], with one Morrocon study demonstrating a prevalence of 34% and a male predominance of 67% [80] Another study demonstrated treatment with anti-TNF-𝛼 monoclonal antibody infliximab reversed excess insulin levels in non-diabetic patients [77]. It is possible to postulate that there might be a Ankylosing Spondylitis Pathogenesis and Pathophysiology DOI: http://dx.doi.org/10.5772/intechopen.109164 relationship between androgen excess metabolic syndrome and the development of AS, but this relationship requires more research to establish.…”

Effects of TNF-α antagonist infliximab on fructose-induced metabolic syndrome in rats

“…7 There is an association between metabolic syndrome and many inflammatory diseases, Previous studies demonstrated a higher prevalence of MS in patients with Psoriasis 8,9 or ankylosing spondylitis. 10,11 Patients with MS have a higher rate of Crohn's disease-related hospitalization compared to those without MS. 12 The inflammatory cytokine, tumor necrosis factor-alpha (TNF-a) plays an important role in the pathophysiology of these inflammatory disorders and in MS. The central role of TNF-a in inflammation has been demonstrated by the ability of agents that block the action of TNF-a to treat a range of inflammatory conditions, including rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease and psoriasis.…”