THU0093 BASAL METABOLIC RATE AND CHARLSON COMORBIDITY INDEX ARE INDEPENDENT PREDICTORS OF METABOLIC SYNDROME IN PATIENTS WITH RHEUMATOID ARTHRITIS

Abstract

Background: Metabolic syndrome (MetS) is associated with 2-fold increase in cardiovascular disease (CVD) and 1.5-fold increase in allcause mortality in the general population. The overall pooled prevalence of MetS in the meta-analysis of rheumatoid arthritis (RA) patients is 30.65%. Along with high prevalence of MetS in RA, several studies showed the contribution of MetS to the increased risk of CVD or cardiovascular mortality in RA patients. Although controversial, the inflammatory activity of RA was significantly associated with MetS in several cross-sectional studies. However, no prospective studies have confirmed an increased risk of MetS development during the course of RA. Objectives: This 2-year prospective study investigated the predictors of metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA). Methods: We recruited 319 consecutive RA patients who did not have MetS at baseline. MetS was defined according to the modified NECP/ATP III 2005 for Asian populations. Predictors of MetS were assessed using univariate and multivariate logistic regression analyses. Results: Of the 247 RA patients who finished 2-year follow-up, 37 (15.0%) developed MetS. At baseline, the patients who developed MetS were older and had higher BMI (P = 0.002), higher waist circumference (P = 0.011), higher waist-hip ratio (P = 0.035), greater skeletal muscle mass (P = 0.005), higher body fat mass (P = 0.011), higher percent body fat (P = 0.004), lower basal metabolic rate (P = 0.004) and higher Charlson comorbidity index score (P < 0.001). The percent of diabetes (P = 0.007) and hypertension (P < 0.001) were higher in patients with MetS than without MetS. And they also had elevated glucose (P = 0.004), triglyceride levels (P < 0.001), and a lower low-density lipoprotein cholesterol (LDL-C) (P < 0.001). These patients were also more likely to take less hydroxychloroquine (P = 0.044), more oral hypoglycemic agents (P < 0.001) and had a lower EQ-5D score (P = 0.025). In the multivariate analysis, when variables that belong to the composition of MetS were excluded, basal metabolic rate (OR = 0.205, 95% CI: 0.078-0.541, P = 0.001) and Charlson comorbidity index score (OR = 2.191, 95% CI: 1.280-3.751, P = 0.004) remained significant predictors of MetS. Conclusion: The development of MetS in RA patients was associated with basal metabolic rate and Charlson comorbidity index at baseline. Physicians should pay more attention to RA patients who have these risk factors to avoid CVD and cardiovascular mortality.