Prevalence and associated risk factors of metabolic syndrome among rheumatoid arthritis patients attending a tertiary teaching hospital in Nairobi, Kenya

Abstract

Background: Rheumatoid Arthritis (RA) predisposes afflicted patients to an increased risk of metabolic syndrome and cardiovascular disease. The prevalence of metabolic syndrome in RA has variably been reported in different populations.
Objective: To determine the prevalence, and associated risk factors, of Metabolic Syndrome (METS) among RA patients.
Methods: Following ethical approval, 127 patients with established RA were recruited. The following parameters were obtained/calculated for further analysis: patients’ demographics, biochemical parameters, waist circumference, BMI and ten-year ASCVD risk. Presence of metabolic syndrome was ascertained as per guidelines. Appraisal of patient and disease features between patients with and those without metabolic syndrome was carried out using the Independent Student’s t and Chi-square tests. Logistic regression was performed to estimate the impact of moderator variables, adjusting for age, sex and baseline characteristics. Throughout the analysis, a p<0.05 was considered statistically significant at a 95% CI.
Results: The mean age of the participants was 51.48±15.7 years while age at diagnosis was 43.29±13.81 years. Median duration of treatment was 6.65 years. Eighty-three patients (65.4%) had a waist circumference above the set cut off, 74 (58.26%) were overweight, 68 (53.5%) were hypertensive, 18 (14.2%) were diabetic while 38 (29.9%) patients had dyslipidaemia. Twenty-seven (21.26%) patients met the criteria for METS. A majority (55.12%) had advanced disease activity. Of the 97 patients aged above 40 years, 52.58% had advanced Cardiovascular Disease (CVD) scores. Univariate analysis, age at diagnosis (OR= 1.07, p<0.001), disease duration (OR= 1.08, p=0.004), disease activity (OR= 1.76, p=0.004), elevated CRP (OR= 1.01, p=0.021) and steroid use (OR= 2.90, p=0.018) were associated with METS.
Conclusion: Metabolic syndrome and its components are highly prevalent and there was sub-optimisation of many of the modifiable risk factors.