Metabolic syndrome in ANCA-associated vasculitis
Daniela R Petermann Smits1, Benjamin Wilde, Makan Kianersi Adegani
1Department of Internal Medicine, Division of Clinical and Experimental Immunology, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Insights
Metabolic syndrome (MetS) is more common in ANCA-associated vasculitis (AAV) patients, indicating a pro-inflammatory state and potentially higher relapse risk. This finding is crucial for understanding cardiovascular risks in AAV.
Area of Science:
- Cardiovascular Medicine
- Rheumatology
- Metabolic Disorders
Background:
- Metabolic syndrome (MetS) is a significant contributor to cardiovascular morbidity and mortality.
- Cardiovascular diseases are a leading cause of death in patients with ANCA-associated vasculitis (AAV).
- The relationship between MetS and AAV remains unexplored.
Purpose of the Study:
- To determine the prevalence of MetS in a cohort of AAV patients.
- To investigate the association between MetS and a pro-inflammatory state in AAV.
- To explore the clinical implications of MetS in AAV, including relapse rates.
Main Methods:
- A cross-sectional study comparing 91 AAV patients with 89 healthy controls (HCs).
- Anthropometric measures and laboratory tests were used to diagnose MetS per NCEP-ATP-III criteria.
- Clinical data, including prednisone use and relapse rates, were analyzed in relation to MetS occurrence.
Main Results:
- The prevalence of MetS was significantly higher in AAV patients (43%) compared to HCs (25%) (P=0.012).
- MetS in AAV was associated with elevated C-reactive protein (CRP) and neopterin levels, indicating a pro-inflammatory state.
- AAV patients with MetS exhibited a higher relapse rate compared to those without MetS.
Conclusions:
- Metabolic syndrome is significantly more prevalent in AAV patients.
- MetS in AAV is linked to increased inflammation and may elevate the risk of disease relapse.
- These findings highlight the importance of addressing MetS in AAV management to mitigate cardiovascular risks and disease flares.
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.
Conclusion:
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.
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