RESEARCH - The metabolic syndrome is amplified in hypothyroid RA patients

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Ann Rheum Dis. Published Online First: 22 December 2008.

doi:10.1136/ard.2008.100776

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Extended Report

The metabolic syndrome is amplified in hypothyroid rheumatoid

arthritis patients: a cross sectional study

H G Raterman 1, I C van Eijk 2, A E Voskuyl 1, M J L s 1, B A C

Dijkmans 1, V P van Halm 1, S Simsek 1, W F lems 1 and M T Nurmohamed

1*

1 VU University Medical Center, Netherlands

2 Jan van Breemen Institute, Netherlands

Abstract

Objectives: Rheumatoid arthritis (RA) patients are at increased risk

for cardiovascular disease (CVD), which is even more pronounced in

hypothyroid RA patients. An unfavourable cardiovascular risk profile

conferred by a higher prevalence of metabolic syndrome (MetS) and a

higher Framingham risk score might explain this amplified

cardiovascular morbidity. Hence, this study compared firstly, MetS

(features) and, secondly, the Framingham 10-year CVD risk in RA

patients with hypothyroidism compared to euthyroid RA patients.

Methods: RA patients participating in the CARRÉ investigation were

divided in two groups: hypothyroid and euthyroid RA patients. MetS

according to the NCEP ATIII-criteria and the Framingham risk score

were compared between hypothyroid and non hypothyroid CVD event-free

RA patients.

Results: In total, 257 RA patients were included: 236 RA (91.8%) and

21 hypothyroid RA (8.2%), respectively. The prevalence of MetS was

significantly higher in hypothyroid RA patients (43%) compared to RA

patients (20%). Moreover, female hypothyroid RA patients had a higher,

Framingham risk score compared to euthyroid RA patients. With RA

patients as reference category, the age and gender adjusted prevalence

OR for MetS was 3.5 (95%-CI: 1.3 – 9.1) in hypothyroid RA.

Conclusions: Hypothyroid RA patients, particularly female patients,

have a more unfavourable cardiovascular risk profile, reflected by

increased prevalence of MetS and higher Framingham score, than

euthyroid RA patients, suggesting a higher need for cardiovascular

risk management in these patients to prevent future CVD events.

http://ard.bmj.com/cgi/content/abstract/ard.2008.100776v1?papetoc

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