title: Cardiovascular and metabolic risk factors in inherited autoinflammation.
abstract: BACKGROUND
  The natural progression of metabolic abnormalities among patients with inherited autoinflammation is unclear.
  
  
  OBJECTIVE
  The objective of the study was to assess the cardiometabolic risk of participants with familial Mediterranean fever (FMF).
  
  
  METHODS
  This study included nationwide cross-sectional and longitudinal cohorts.
  
  
  METHODS
  The prevalence of components of the metabolic syndrome at age 17 years was assessed from the medical database of the Israeli Defense Force from 1973 through 1997. Included were 745 males with FMF, 902 healthy male siblings, and a control group of 787,714 participants. A prospective follow-up study traced the incidence of components of the metabolic syndrome to age 45 years among 57 FMF and 1568 control army personnel participants.
  
  
  METHODS
  Body mass index (BMI) and blood pressure (BP) were measured at age 17 years (cross-sectional); lifestyle, anthropometric, and biochemical data were periodically recorded from age 25 years.
  
  
  METHODS
  Abnormal BMI or BP (age 17 y) and Adult Treatment Panel III criteria of the metabolic syndrome were measured.
  
  
  RESULTS
  In multivariable regression analysis adjusted for known confounders of obesity, FMF participants had an odds ratio of 0.65 for the occurrence of overweight [95% confidence interval (CI) 0.44-0.96, P = .03] and 0.66 (95% CI 0.48-0.92, P = .012) for hypertension-range BP; their siblings tended to obesity (odds ratio 1.48; 95% CI 1.04-2.11, P = .008). In the follow-up arm, a multivariable analysis adjusted for age, birth year, BMI, education, socioeconomic status, ethnicity, and physical activity yielded hazard ratios of 0.32 (95% CI 0.10-0.82, P = .002) for incident obesity, 0.49 (95% CI 0.25-0.95, P = .037) for incident triglycerides 150 mg/dL or greater, 0.56 (95% CI 0.31-0.98, P = .048) for low-density lipoprotein cholesterol 130 mg/dL or greater, and 2.14 (1.368-3.359, P = .001) for high-density lipoprotein cholesterol less than 40 mg/dL for FMF participants compared with controls. Incident elevated BP was lower among FMF participants (hazard ratio 0.49; 95% CI 0.23-1.00, P = .05), whereas dysglycemia incidence was comparable.
  
  
  CONCLUSIONS
  FMF is associated with lower rates of most components of the metabolic syndrome compared with normal subjects, unlike other inflammatory conditions.
authors: Departments of Medicine B (G.T., D.B.-A.S., H.A.), Department of Medicine F (A.L., I.B.-Z.), and Pediatrics (A.V.), and Heller Institute of Medical Research (A.L., I.B.-Z.), The Pinchas Borenstein Talpiot Medical Leadership Program 2012 (G.T., A.V., I.B.-Z., Y.A.), Chaim Sheba Medical Center, Tel Hashomer 52621, Israel; The Israel Defense Forces Medical Corps (G.T., A.V., E.D., A.L., D.T., A.F.), Israel; The Sackler School of Medicine (A.L., A.V., A.A., E.D., C.M., I.B.-Z., Y.A., H.A.), Tel Aviv University, Tel Aviv 69978, Israel; The Israeli Ministry of Health (A.A.), Israel; Department of Medicine I (A.F.), Tel Aviv Medical Center, Tel Aviv 69978, Israel; and Department of Cardiology (M.I.), Maria Vittoria Hospital, 10126 Torino, Italy.
authors: Gilad
authors: G
authors: Twig
authors: Avi
authors: A
authors: Livneh
authors: Asaf
authors: A
authors: Vivante
authors: Arnon
authors: A
authors: Afek
authors: Estela
authors: E
authors: Derazne
authors: Adi
authors: A
authors: Leiba
authors: Dana Ben-Ami
authors: DB
authors: Shor
authors: Chanan
authors: C
authors: Meydan
authors: Ilan
authors: I
authors: Ben-Zvi
authors: Dorit
authors: D
authors: Tzur
authors: Ariel
authors: A
authors: Furer
authors: Massimo
authors: M
authors: Imazio
authors: Yehuda
authors: Y
authors: Adler
authors: Howard
authors: H
authors: Amital
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000276:immunology; D056660:Hereditary Autoinflammatory Diseases / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000276:immunology; D008889:Military Personnel / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology* / Q000276:immunology; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D055815:Young Adult