Association of Severe Disease Activity with Metabolic Syndrome in Patients with Early Rheumatoid Arthritis: A Cohort Study from Tertiary Care Hospital of Pakistan

Abstract

Background: The peripheral joints are particularly vulnerable to the autoimmune disease rheumatoid arthritis. Patients with rheumatoid arthritis often exhibit symptoms of metabolic syndrome. Metabolic syndrome in rheumatoid arthritis is connected with increased morbidity and death. Objective: This study aimed to examine whether or not rheumatoid arthritis patients who had high levels of disease activity also developed metabolic syndrome. Methods: The cohort study was conducted on 64 patients (32 in each group), included via Non-probability convenient sampling. Disease activity score of 28 joints (DAS-28 score) was used to assess the severity of disease activity in patients of rheumatoid arthritis and two groups were developed i.e. group I with score ≥3.2 and group II with score <3.2. Patients were then assessed for metabolic syndrome. All data was analyzed in SPSS version 21.0. The association between severe disease activity and metabolic syndrome was calculated as relative risk. Results: The mean age of patients in group I & II was 31.26 ± 5.07 years & was 33.57 ± 3.73 years respectively. The mean DAS-28 score of patients in group I was 4.93 ± 0.79 while in group II was 2.32 ± 0.40 and the difference between both groups for DAS-28 score was highly significant (p<0.001). Metabolic syndrome was diagnosed in 13 (40.6%) patients in group I while in 3 (9.4%) patients in group II. The difference was significant, association observed between metabolic syndrome and severity of disease i.e. Relative risk = 2.053 (95% confidence interval: 1.347, 3.128, p-value = 0.0094). Conclusion: Rheumatoid arthritis patients who also have metabolic syndrome tend to have more severe illness.