Metabolic syndrome and cardiovascular-kidney-metabolic health: evaluation of predictive risk factor for mortality in systemic sclerosis

Highlights•MetS, regardless of the classifications used, has a high prevalence in SSc patients•SSc patients with MetS had higher rate of death for any cause not-SSc related•MetS should be considered among the risk factors for SSc mortalityAbstractBackground and aimsFew studies have addressed the MetS in systemic sclerosis (SSc) patients. Several classifications have been proposed to define metabolic syndrome (MetS). The aim of the study was to evaluate if MetS and cardiovascular-kidney-metabolic health assessment may predict mortality in SSc patients during a 10-year follow-up.Methods and ResultsNinety consecutive SSc patients were enrolled. The diagnosis of MetS was made according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III), NCEP-R, International Diabetes Federation (IDF) and cardiovascular-kidney-metabolic syndrome (CKM) classification. Mortality was observed in 21 (23.3%) SSc patients. Kaplan-Meier curves showed that overall survival probability was shorter in patients with MetS according to NCEP-ATPIII (p<0.001), NCEP-R (p<0.05) and IDF (p<0.05) compared to patients without MetS; while the overall survival was similar in patients with CKM 0-1 and patients with CKM 2-3-4. Cumulative incidence rate of SSc-related death was similar in patients with MetS according to NCEP-ATPIII, NCEP-R and IDF compared to patients without MetS and in patients with CKM 0-1 and patients with CKM 2-3-4. Cumulative incidence rate for all-cause mortality not-SSc related was higher in patients with MetS according to NCEP-ATPIII (p<0.001), NCEP-R (p<0.01) and IDF (p<0.01) compared to patients without MetS; while the cumulative incidence rate all-cause mortality not-SSc related was similar in patients with CKM 0-1 and patients with CKM 2-3-4.ConclusionsMetS is a risk factor for all-cause mortality in SSc patients but not related to underlying disease.