Clinical & Demographic Profile and Prevalence of Metabolic Syndrome Among Patients with Rheumatoid Arthritis and its Correlation with Disease Activity.

Rheumatoid arthritis (RA) is a chronic, symmetric, systemic inflammatory polyarthritis of unknown etiology. It primarily affects small diarthrodial joints of hand and has higher prevalence in women just like any other autoimmune disease. Metabolic Syndrome (MS) is a constellation of cardiovascular risk factors with insulin resistance as a core manifestation. Dyslipidemia, central obesity and hypertension form the other manifestations. Both the disorders share the common pathophysiology which centres around chronic systemic inflammation. High plasma levels or TNF and interleukins are found in both. The present work is a modest attempt to study the prevalence of metabolic syndrome among patients with rheumatoid arthritis and its correlation with disease activity.The study was carried out in a total of 100 rheumatoid arthritis patients enrolled as cases and compared with 100 age and sex matched non rheumatoid arthritis controls at R.N.T. Medical college and attached group of hospitals, Udaipur. It was an observational case control study done over a period of 1 year.In the present study, the prevalence of MS was 32% in RA patients and 14% in general population, with the difference being statistically significant. Females were more commonly affected by RA than males, however the prevalence of MS among both was similar. Statistical significance difference was noted in BMI (p=0.039) and FPG (p=0.008) among cases and controls. Significant association with MS among RA patients was also found with those who had pain, longer duration of illness, RF positivity, raised CRP and elevated ESR. The study didn't find correlation with RA disease activity and prevalence of MS.There exists a complex interplay between rheumatoid arthritis and metabolic syndrome with chronic systemic inflammation playing a major role. The prevalence of MS and associated atherosclerotic cardiovascular risk is increased among RA patients. Further research in this arena is required to mitigate the morbidity and mortality among RA patients.