Prevalence of metabolic syndrome in patients with rheumatoid arthritis in Morocco: a cross-sectional study of 179 cases

Rheumatoid arthritis (RA) is associated with an increased risk for cardiovascular disease (CVD). The prevalence of metabolic syndrome (MetS)-a major contributor to CVD-in RA seems to be increased, suggesting that systemic inflammation and antirheumatic therapy may contribute to its presence. We aimed to determine the prevalence of MetS in RA, to identify the potential factors associated with its presence, and to evaluate the influence of antirheumatic drugs on the occurrence of MetS in a cohort of Moroccan patients with RA. The prevalence of MetS was assessed cross-sectionally in 179 patients with RA over a period of 17 months (July 2011-December 2012). Three definitions of MetS were used (National Cholesterol Education Program/Adult Treatment Panel III 2005, International Diabetes Federation 2005, and American Association of Clinical Endocrinologists 2003). All statistical analyses were done using the SPSS software version 18.0. Multivariate logistic regression model was constructed to identify independent predictors of MetS in patients with RA. The prevalence of MetS in RA varied from 24.6 to 30.7 % according to the definitions used. In a multivariate logistic regression model, the severity of RA and less methotrexate use were identified as significant independent predictors of the presence of MetS in RA patients. Our study suggests that MetS is common among Moroccan patients with severe RA. Methotrexate therapy was identified as an independent factor associated with a reduced risk of having MetS in these patients, suggesting a drug-specific mechanism and making methotrexate a first-line disease-modifying antirheumatic drug in RA patients who are at high risk of developing MetS.