Romatoid Artrit ve Ankilozan Spondilitli Hastalarda Metabolik Sendrom

Year 2018, Volume: 18 Issue: 2, 198 - 206, 25.06.2018

Bilge Kesikburun , Emel Ekşioğlu Aytül Çakcı

https://doi.org/10.17098/amj.435258

Abstract

Amaç: Romatoid artrit (RA) ve ankilozan
spondilitli (AS) hastalarda insülin direnci ve metabolik sendrom (MetS) prevalansını
değerlendirmek ve karşılaştırmak, MetS’in hastalık aktivitesi ile ilişkisini ve
MetS ile ilişkili faktörleri belirlemektir.

Materyal ve Metot: Kesitsel çalışma toplam
174 RA ve AS’li hasta içermektedir. MetS Uluslarası Diabet Federasyonu
Kriterleri’ne (IDF) göre tanımlandı. İnsülin direnci Homeostas Model Assesment
Index (HOMA) ile değerlendirildi. Hastalık aktivitesini ölçmek için 28 eklemi
içeren hastalık aktivite skoru (DAS 28) ve Bath Ankilozan Spondilit Hastalık
Aktivite İndeksi (BASDAI) kullanıldı. Fonksiyonel durumu Bath Ankilozan
Spondilit Fonksiyonel İndeksi (BASFI) ve sağlık değerlendirme ölçeği (HAQ)
kullanılarak değerlendirildi. MetS belirleyicilerini tanımlamak için çoklu
regresyon analizi kullanıldı.

Bulgular: MetS prevalansı RA’lı
hastalarda (%47) AS’li (%24,56) hastalardan daha yüksekti (p=0.005). İnsülin
direnci prevalansı RA’lı hastalarda (%34,18) AS’li (%17,54) hastalardan daha
yüksekti (p=0.031). MetS olan ve olmayan RA ve AS’li hastalar arasında hastalık
aktivite skorları arasında anlamlı fark bulunmadı. (sırasıyla p=0,580 ve p=0,158).
Yüksek BASDAI skorlarına sahip hasta sayısı MetS’li AS hastalarında daha
yüksekti. Yaş ve vücut kitle indeksinin MetS için belirleyici olduğu saptandı
(sırasıyla p=0,015 ve p<0,001).

Sonuç: AS’li hastalarla
karşılaştırıldığında RA’lı hastalarda MetS ve insülin direnci yüksek oranda
görüldü. MetS komponentlerinin ve hastalık aktivitesinin daha iyi kontrolü
romatolojik hastalarda MetS prevalansının azalmasına yardımcı olabilir. 

Keywords

Metabolik sendrom, romatoid artrit, ankilozan spondilit, hastalık

Metabolic Syndrome in Rheumatoid Arthritis and Ankylosing Spondylitis

Abstract

Objectives: To evaluate and compare the prevalence of insulin resistance and metabolic syndrome (MetS) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and to determine the relationship of MetS with disease-activities and the factors associated with MetS.

Materials and Methods: The cross-sectional study included a total of 174 patients with RA and AS. MetS was defined according to the International Diabetes Federation (IDF) criteria. Insulin resistance was assessed with the Homeostasis Model Assessment (HOMA) Index. The Disease Activity Score including 28 joints (DAS28) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were used to measure disease activity. Functional status was evaluated using the Health Assessment Questionnaire (HAQ) and the Bath Ankylosing Spondylitis Functional Index (BASFI). Logistic regression analysis was applied to identify predictors of metabolic syndrome.

Results: The prevalence of MetS was significantly higher in patients with RA (47%) than in patients with AS (24.56%) (p=0.005). The prevalence of insulin resistance was significantly higher in patients with RA (34.18%) than in patients with AS (17.54%)(p=0.031). No significance difference was found in the disease activity score between RA and AS patients with metabolic syndrome and without metabolic syndrome (p=0.580 and p=0.158, respectively). The number of patients with a higher BASDAI score was greater in AS patients with MetS. Age and body mass index were determined to be predictors for MetS (p=0.015 and p<0.001, respectively).

Conclusion: Higher rates of MetS and insulin resistance were seen in RA patients compared to the patients with AS. Better control of the MetS components and disease activity may help to decrease the prevalence of MetS in rheumatic disease.

Keywords

Metabolic syndrome, rheumatoid arthritis, ankylosing spondylitis, disease

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