Interrelationship of Metabolic Syndrome and Rheumatoid Arthritis in North Indian Population

Abstract

Objective: The metabolic syndrome (MetS) may be responsible for occurrence of high frequency of cardiovascular disease in rheumatoid arthritis (RA) patients. An association between inflammatory activity of RA and MetS has also been speculated. This study was designed to see whether presence of MetS along with RA increases the severity of disease and to find the risk association of the disease severity markers of RA namely TNF-α, anti-CCP, RF, CRP and ESR with MetS. Methodology: 185 patients of RA (EULAR 2010) were recruited and assessed for MetS according to NCEP/ATP III criteria. Serum level of disease specific biomarkers of RA namely TNF-α, anti-CCP, RF, CRP and ESR were quantified in all patients and compared between RA with MetS and only RA patients. Cytokine TNF-α, anti-CCP, RF, and CRP were assayed through ELISA. Results: The prevalence of MetS among RA patients was 41.2%. The mean age of RA cases with MetS is significantly older (55.65yrs) with increased disease duration. The levels of TNF-α, anti-CCP, CRP and ESR along with EULAR & DAS score were significantly (p<0.05) high in RA with MetS. TNF-α showed maximum risk (OR=6.3; p=0.03) in development of MetS. Longer disease duration with high anti-CCP, CRP and DAS-28 were also contributing significantly in MetS development. Conclusion: A positive vicious cycle is working between the pathogenesis of RA and MetS through inflammatory cytokines and biomarkers. MetS in RA is associated with increased disease severity. Keywords: Rheumatoid arthritis, Metabolic syndrome, Biomarkers, Cytokine TNF-α, Disease severity