RESEARCH - The metabolic syndrome is amplified in hypothyroid RA patients

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Ann Rheum Dis 2010;69:39-42 doi:10.1136/ard.2008.100776

Clinical and epidemiological research

Extended report

The metabolic syndrome is amplified in hypothyroid rheumatoid

arthritis patients: a cross-sectional study

H G Raterman1, I C van Eijk2, A E Voskuyl1, M J L s1, B A C

Dijkmans1,2, V P van Halm1, S Simsek3, W F Lems1, M T Nurmohamed1,2,3

+ Author Affiliations

1Department of Rheumatology, VU University Medical Center, Amsterdam,

The Netherlands

2Department of Rheumatology, Jan van Breemen Institute, Amsterdam, The

Netherlands

3Department of Internal Medicine, VU University Medical Center,

Amsterdam, The Netherlands

Abstract

Objectives: 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 CARRÉ 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.

http://ard.bmj.com/content/69/01/39.abstract?etoc

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