title: Prevalence of metabolic syndrome in women with rheumatoid arthritis and effective factors.
abstract: OBJECTIVE
  Metabolic syndrome (MS), which is framed by cardiovascular risk factors such as hypertension, obesity, glucose intolerance and dyslipidemia, is thought to be associated with the rheumatic diseases. The aim of this study is to examine the frequency of metabolic syndrome (MS) and insulin resistance in patients with rheumatoid arthritis (RA) and to examine the effect of the inflammation symptoms, disease activity and drugs used in treating RA on insulin resistance and presence MS.
  
  
  METHODS
  One hundred women patients diagnosed with RA according to the American College of Rheumatology (ACR) diagnosis criteria and 100 healthy women were included in the study as controls. Insulin resistance were evaluated using the homeostasis model assessment for insulin resistance (HOMA-IR) method and MS was diagnosed according to two Metabolic Syndrome definitions (National Cholesterol Education Programme 2004, International Diabetes Federation). The disease activity of RA was evaluated by the disease activity score including 28 joints (DAS28).
  
  
  RESULTS
  In total, 27% and 33% of the RA patients and 28% and 44% of the control group patients according to the diagnostic criteria used were also MS patients. There was no significant difference between the RA and control groups in MS frequency and insulin resistance according to two diagnostic criteria used. The DAS28, erythrocyte sedimentation speed (ESS) and serum uric acid levels in the RA patients with MS were significantly higher than those of the RA patients without MS. The prevalence of MS İn patients with RA using methotrexate (MTX) was significantly lower than without RA. Other drugs used in treatment of RA had no effect on the prevalence of MS in patients with RA.
  
  
  CONCLUSIONS
  Controlling inflammation and disease activity can reduce the MS frequency of RA patients and MTX treatment also may be a protective factor against MS.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Sinop Ataturk State Hospital Sinop, Turkey.
authors.forename: Nilüfer Aygün
authors.initials: NA
authors.lastname: Bilecik
authors.affiliation: Department of Physical Medicine and Rehabilitation, Sinop Ataturk State Hospital Sinop, Turkey.
authors.forename: Serpil
authors.initials: S
authors.lastname: Tuna
authors.affiliation: Department of Physical Medicine and Rehabilitation, Sinop Ataturk State Hospital Sinop, Turkey.
authors.forename: Nehir
authors.initials: N
authors.lastname: Samancı
authors.affiliation: Department of Physical Medicine and Rehabilitation, Sinop Ataturk State Hospital Sinop, Turkey.
authors.forename: Nilüfer
authors.initials: N
authors.lastname: Balcı
authors.affiliation: Department of Biochemistry, Akdeniz University Medical School Antalya, Turkey.
authors.forename: Halide
authors.initials: H
authors.lastname: Akbaş
keywords: HOMA-IR; MTX; Metabolic syndrome; insulin resistance; rheumatoid arthritis