Coexistence of metabolic syndrome and primary antiphospholipid syndrome is associated with arterial events

Abstract

Objective: Metabolic syndrome (MetS) is highly prevalent in rheumatic diseases and it is recognized as a new independent cardiovascular risk factor. This study was undertaken to determine the clinical significance of MetS in patients with primary antiphospholipid syndrome (PAPS). Methods: 71 PAPS patients and 73 age- and gender-matched healthy controls were included. Sera samples were tested for lipid profile, liporotein(a), glucose, insulin, TSH, free T4, ESR, CRP and uric acid. MetS was defined by the International Diabetes Federation criteria and insulin resistance was established using the homeostasis model assessment index. Results: The prevalence of the MetS was 33.8% and further comparison between PAPS patients with and without MetS revealed that the former had a higher frequency of arterial events (79.2 vs. 42.6%, P=0.003), angina (29.2 vs. 2.1%, P=0.002) and positive lupus anticoagulant antibody (95.8 vs. 76.6, P=0.049). In addition, they had, as expected, a higher prevalence of cardiovascular risk factors. On multivariate analysis only MetS was independently associated with arterial events in PAPS. Conclusion: Coexistence of PAPS and MetS seems to identify a subgroup of patients with higher risk of arterial events suggesting that MetS may aggravate existing endothelial abnormalities of PAPS. © 2012 by the American College of Rheumatology