Correlation Between Disease Activity And Metabolic Syndrome In Patients With Rheumatoid Arthritis

Backgroud and Objective Rheumatoid arthritis(RA)is a chronic,systemic autoimmune disease characterized by aggressive symmetric polyarthritis.At present,the pathogenesis is not clear.The main pathological changes were synovitis,pannus formation,articular cartilage and bone destruction,which resulted in joint deformity and loss of function.RA can also involve multiple systemic organs,including the blood system,the respiratory system,and the cardiovascular system.The prevalence of RA in China was 0.32%-0.36%.RA may occur at all ages,with a peak age of 30 to 50 years.The incidence of RA is more common in women than in men.In addition,the disease activity of RA patients is also related to joint destruction.Early intervention and treatment of RA is the key to prevent joint destruction and disability.Metabolic syndrome,also known as syndrome X and insulin resistance,was first proposed by Reaven in 1988.Metabolic syndrome includes insulin resistance,hyperglycemia,obesity,hypertension and dyslipidemia.With the development of social economy and the change of life style,the incidence of metabolic syndrome is increasing year by year,which is one of the important causes of cardiovascular disease and death.In recent years,RA is considered to be an independent risk factor for cardiovascular disease,and its increased cardiovascular risk may be related to metabolic syndrome.At present,the correlation between disease activity and MS in RA patients is not very clear.Previously,most previous studies on RA and MS suggested that the incidence of MS in RA patients was higher than that in normal controls.Therefore,it is particularly important to study the association of disease activity with MS in RA patients.The purpose of this study was to study the correlation between disease activity and MS in RA patients,prevent and intervene early,so as to delay disease progression,improve survival rate and improve quality of life.Subject and Methods From September 2016 to April 2017,147 patients with rheumatoid arthritis were admitted to the Department of Rheumatology and Immunology in the first affiliated Hospital of Zhengzhou University.There were 147 cases of rheumatoid arthritis,including 41 males and 106 females.Patients with metabolic syndrome were divided into simple RA group and RA with MS group.The average age of 101 patients in RA group was 55.66 ±11.77 years old,including 30 males and 71 females.The mean age of 46 RA patients with MS was 57.09 ±12.32 years old,including 11 males and 35 females.Statistical analysis: the data of RA and MS were collected.The data were analyzed by SPSS17.0 software.The counting data are represented by frequency(composition ratio),chi-square test,mean ±standard deviation and independent sample t test are used for counting data.Logistic regression analysis was used to study the independent influencing factors.The difference was statistically significant(p < 0.05).Result The comparison of general data between RA group and RA combined with MS group showed that the sex ratio,age,course of disease of RA group and RA combined with MS group were higher than those of RA group.There was no significant difference in the history of cardiovascular disease(P > 0.05).The proportion of RA with MS in patients with diabetes mellitus was higher than that in RA alone(P < 0.05).The waist circumference,blood pressure,FBG,TG,ESR,CRP and DAS28(ESR)in RA combined with MS group were significantly higher than those in the simple RA group.The RA and MS group were significantly lower than those in the simple group.The increase rate of waist circumference,blood pressure,fasting blood glucose and triglyceride in RA with MS group was higher than that in simple RA group,while the decrease rate of HDL in RA combined with MS group was higher than that in simple RA group.Multivariate Logistic regression analysis showed that all the patients with diabetes mellitus were able to enter the equation(P < 0.05).Conclusion 1.Disease activity and Metabolic Syndrome in patients with Rheumatoid Arthritis(RA)and Metabolic Syndrome(MS)are associated with CRP,ESR and DAS28.Diabetes is an independent risk factor for MS.2.The proportion of metabolic components in RA patients with MS is higher than that in patients with simple RA.