Athrogenic indexes: Useful markers for predicting metabolic syndrome in axial spondyloarthritis

Metabolic syndrome is a pathological entity associated with a high risk of cardiovascular disease. Data regarding the frequency of this syndrome, lipid profile, and atherogenic index of plasma in patients with radiographic axial spondyloarthritis are scarce. We aim to determine the prevalence of metabolic syndrome in patients with spondyloarthritis. We also aim to determine discriminative values of atherogenic indexes between patients with and without metabolic syndrome.

We conducted a cross-sectional study including 51 patients meeting the ASAS 2009 criteria for radiographic axial spondyloarthritis. We measured the following parameters: triglyceride (TG), high-density lipoproteins (HDL_c), low-density lipoprotein cholesterol (LDL_c), and total cholesterol (TC). We calculated TC/HDL_c, TG/HDL_c, LDL_c/HDL_c ratios, and atherogenic index of plasma (LogTG/HDL_c).

Metabolic syndrome was noted in 33% of cases. Patients with active disease had a higher body mass index (26.89±5.88 versus 23.63±4.47kg/m², p=0.03), higher TG (1.41±0.64 versus 0.89±0.5mmol/L, p=0.05) and a lower HDL_c level (1±0.28 versus 1.31±0.22mmol/L, p=0.01). However, the LogTG/HDL_c and TG/HDL_c were higher in patients under TNFα inhibitors. The ability of the TG/HDL_c ratio and LogTG/HDL_c to distinguish patients with or without metabolic syndrome were good at cut-offs of 1.33 and 0.22, respectively (specificity: 91.2% and sensitivity 70.6% for both ratios).

Our study showed that metabolic syndrome is frequent in patients with axial spondyloarthritis. Atherogenic indexes can be used for predicting metabolic syndrome in these patients.