The metabolic syndrome is amplified in hypothyroid rheumatoid arthritis patients: a cross-sectional study.
OBJECTIVE
Rheumatoid arthritis (RA) patients are at increased risk of cardiovascular disease (CVD), which is even more pronounced in hypothyroid RA patients. An unfavourable cardiovascular risk profile conferred by a higher prevalence of the metabolic syndrome (MetS) and a higher Framingham risk score might explain this amplified cardiovascular morbidity. This study compared first, MetS (features) and second, the Framingham 10-year CVD risk in RA patients with hypothyroidism compared with euthyroid RA patients.


METHODS
RA patients participating in the CARRE investigation were divided into two groups: hypothyroid and euthyroid RA patients. MetS according to the National Cholesterol Education Program Third Adult Treatment Panel criteria and the Framingham risk score was compared between hypothyroid and non-hypothyroid CVD event-free RA patients.


RESULTS
In total, 257 RA patients were included: 236 with RA (91.8%) and 21 with hypothyroid RA (8.2%), respectively. The prevalence of the MetS was significantly higher in hypothyroid RA patients (43%) compared with RA patients (20%). Moreover, female hypothyroid RA patients had a higher Framingham risk score compared with euthyroid RA patients. With RA patients as the reference category, the age and gender-adjusted prevalence odds ratio for the MetS was 3.5 (95% CI 1.3 to 9.1) in hypothyroid RA.


CONCLUSIONS
Hypothyroid RA patients, particularly female patients, have a more unfavourable cardiovascular risk profile, reflected by an increased prevalence of the MetS and higher Framingham score, than euthyroid RA patients, suggesting a greater need for cardiovascular risk management in these patients to prevent future CVD events.
Raterman
H G
HG
VU University Medical Centre, Departments of Internal Medicine and Rheumatology, 1007 MB Amsterdam, The Netherlands.
van Eijk
I C
IC
Voskuyl
A E
AE
Peters
M J L
MJ
Dijkmans
B A C
BA
van Halm
V P
VP
Simsek
S
S
Lems
W F
WF
Nurmohamed
M T
MT
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D002318:Cardiovascular Diseases / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D012737:Sex Factors