Öz
Amaç
Bu çalışmanın amacı farklı romatizmal hastalıklarda metabolik sendromun (MetS) sıklığını değerlendirmek ve hastalık özellikleri, aktivitesi ve/veya şiddetiyle ilişkisini incelemektir.
Yöntem
İki yüz elli yedi hasta [47 romatoid artrit (RA), 100 sistemik lupus eritematozus (SLE), 49 sistemik skleroz (SSc), 33 aksiyel spondiloartrit (axSpA) ve 28 vaskülit (21’i primer vaskülit ve 7’si Behçet hastalığı (BH)] ve 70 kontrol, ilgili her hastalık için uygun sayıda kontrol eşleştirilerek alınmıştır. Demografik veriler, vücut kitle indeksi, bel çevresi, komorbiditeler ve klinik ve laboratuvar verileri toplanmıştır. Hastalık aktivitesi ve/veya şiddeti belirlenmiştir. MetS, Yetişkin Tedavi Paneli kriterlerine göre tanımlanmıştır.
Bulgular
RA’da MetS, hastalık aktivite skoru ile anlamlı bir ilişkisi olmayan kontrol grubu ile karşılaştırılabilir düzeydeydi (p=0,33), ancak aktivite derecelendirmesine göre anlamlı bir fark vardı (p=0,007). SLE’de MetS, kontrol grubuna (%14,9) kıyasla anlamlı derecede daha sık (%42) görülmüş (p=0,001) ve hastalık aktivitesiyle anlamlı derecede ilişkili bulunmuştur (p=0,001). SSc, axSpA ve vaskülitte, MetS sıklığı karşılık gelen kontrollerle karşılaştırılabilirdi (p=0,24, p=0,4, p=0,08) ve hastalık aktivite skorlarıyla ilişkili değildi (sırasıyla p=0,7, p=0,4, p=0,97); ayrıca BH aktivitesi ve hasarı için p=0,45 ve p=0,14 idi. Farklı romatizmal hastalıklar karşılaştırıldığında, MetS SLE’de anlamlı olarak daha sık görülmüştür (p=0,04). MetS bileşenleri açısından, SLE’de diğer romatizmal hastalıklara kıyasla anlamlı derecede daha yüksek hipertansiyon (p<0,0001) ve anlamlı derecede daha yüksek trigliserit (p=0,004) sıklığı vardı. Nötrofil-lenfosit oranı ve trombosit-lenfosit oranı ile MetS arasında RA (p=0,4, p=0,4), SLE (p=0,35, p=0,73), SSc (p=0,46, p=0,14), axSpA (p=0,35, p=0,45) ve vaskülitte (p=0,72, p=0,29) anlamlı bir ilişki bulunmamıştır.
Sonuç
MetS, romatizmal hastalıklarla sıklıkla ilişkilidir, SLE’de önemli ölçüde daha sık görülür ve hastalık aktivitesi ile ilişkili olabilir.
Anahtar Kelimeler: Romatizmal hastalıklar, metabolik sendrom (MetS), hastalık aktivitesi, şiddet
Kaynakça
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