Association between cardiovascular risk factors and the occurrence of giant cell arteritis: a systematic review and meta-analysis

Abstract Objectives We aimed to analyze the association between cardiovascular risks factors and the onset of giant cell arteritis (GCA) through a systematic review and meta-analysis of observational studies. Methods Three databases (MEDLINE, EMBASE, WEB OF SCIENCE) were systematically reviewed. Epidemiological studies on the association between six cardiovascular risk factors (type 2 diabetes, hypertension, dyslipidaemia, smoking, overweight/obesity, history of a cardiovascular disease) and the risk of GCA were eligible. Risk of bias was assessed using the ROBINS-E scale. Pooled associations for studies assessing the same outcome were reported as odds ratios (OR) and their 95% confidence interval (CI). Results The search strategy identified 4,210 references, of which 43 studies were analyzed and 17 were included in the meta-analysis (11 case-control studies, four cohort studies). An inverse association was found between type 2 diabetes and risk of GCA (OR = 0.75, 95% CI 0.61–0.93) and whereas history of cardiovascular disease was positively associated with GCA with risk (OR = 1.28, 95% CI 1.18–1.38). We found a trend towards a decreased risk of GCA in overweight participants (OR 0.64; 95% CI 0.41–1.00). Conclusion Our study showed an inverse association of type 2 diabetes and a positive association of a history of cardiovascular disease with GCA risk. There is also a trend towards an inverse association with overweight. The pathophysiological mechanisms underlying these findings may involve an effect of cardiovascular risk factors themselves, a condition underlying these factors such as diet, or a condition following their diagnosis such as their treatment.