類風濕性關節炎病人的代謝症候群與生活習慣及體位測量相關性之研究

Metabolic syndrome in patients with rheumatoid arthritis: association of lifestyle with anthropometric measurements

目的：代謝症候群是心血管疾病的危險因子，類風濕性關節炎是一種慢性發炎性疾病同時也增加了心血管疾病的危險性，本研究探討類風濕性關節炎病人的代謝症候群與生活習慣及體位測量相關性。方法：本研究於2008年12月至2009年6月間於門診收集86位類風濕性關節炎病人有關高血壓、高血糖、高血脂的問卷，另外又由國民健康局的資料庫中隨機抽樣172位年齡與性別吻合的對照組。結果：類風濕性關節炎病人的代謝症候群盛行率（26.7%）較對照組高（22.1%），類風濕性關節炎病人有代謝症候群的DAS28較無代謝症候群者高（4.66 ± 0.17 vs. 4.00 ± 0.12, p<0.05），類風濕性關節炎病人比起對照組有較高的總膽固醇、高密度膽固醇及收縮血壓，較低的低密度膽固醇及三酸甘油酯，類風濕性關節炎病人中有代謝症候群的家族有糖尿病或高血壓較無代謝症候群的病人高。結論：類風濕性關節炎造成的慢性發炎反應可能是代謝症候群盛行率高的原因，應該多鼓勵類風濕性關節炎病人積極的控制疾病。

Objective: Metabolic syndrome (MS) is a clustering of major risk factors for the occurrence of cardiovascular disease (CVD). Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with an increased CVD risk. In this prospective study, we evaluated the rate of MS and the association of lifestyle with anthropometric measurements in RA patients. Method: We enrolled 86 RA patients who attended a hypertension, hyperglycemia, hyperlipidemia questionnaire assessment clinic between December 2008 and June 2009. In addition, we randomly selected 172 age- and sex-matched controls from the database of the Bureau of Health Promotion, the Department of Health, in Taiwan. Results: The rate of MS was higher in RA patients (26.7%) than in controls (22.1%), but there was no statistical significance. A significantly higher DAS28 was observed in RA patients with MS than in those without MS (4.66 ± 0.17 vs. 4.00 ± 0.12, p<0.05). Significantly higher levels of total cholesterol, HDL-C, and systolic blood pressure, and significantly lower levels of fasting glucose, LDL-C and TG were observed in RA patients than in controls. The occurrence rate of family history of diabetes and hypertension was higher in RA patients with MS than in those without MS. Conclusion: Chronic inflammation status of RA plays an important role in the risk of developing MS. Our results suggest that RA patients should be control their disease activity aggressively.