title: Metabolic syndrome in ANCA-associated vasculitis.
abstract: OBJECTIVE
  The metabolic syndrome (MetS) is a cluster of cardiovascular risk factors and a major cause of morbidity and mortality in the western world. Despite the fact that cardiovascular diseases are a major cause of mortality in patients with ANCA-associated vasculitis (AAV), the relationship between MetS and AAV has not yet been explored. Thus it is the aim of this study to investigate the prevalence of MetS within a cohort of patients with AAV and to assess whether MetS in AAV is associated with a pro-inflammatory state.
  
  
  METHODS
  Ninety-one patients with AAV were compared with 89 healthy controls (HCs) in a cross-sectional study. Both groups underwent anthropometric measures and laboratory tests to determine the prevalence of MetS in accordance with the National Cholesterol Education Program Adults Treatment Panel III (NCEP-ATP-III) definitions. Furthermore, the clinical course of AAV was related to the occurrence of MetS.
  
  
  RESULTS
  Within the AAV patient group, 39 (43%) fulfilled the NCEP-ATP-III criteria for MetS compared with 22 (25%) of the controls (P = 0.012). This difference in prevalence could not be explained by current or cumulative prednisone use in patients with AAV. Among patients with AAV, the presence of MetS was significantly associated with increased levels of CRP and neopterin. Finally, the relapse rate was higher in patients with MetS as compared with those without MetS.
  
  
  CONCLUSIONS
  The prevalence of MetS is significantly increased in AAV. MetS is associated with a more pro-inflammatory state in AAV and might increase the risk of developing a relapse of AAV.
authors.affiliation: Department of Internal Medicine, Division of Clinical and Experimental Immunology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
authors.forename: Daniela R
authors.initials: DR
authors.lastname: Petermann Smits
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wilde
authors.forename: Makan
authors.initials: M
authors.lastname: Kianersi Adegani
authors.forename: Heiko
authors.initials: H
authors.lastname: de Jongh
authors.forename: Pieter
authors.initials: P
authors.lastname: van Paassen
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Cohen Tervaert
mesh_terms: D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D055105:Waist Circumference