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Metabolic Syndrome and Its Components Among Rheumatoid Arthritis Patients: A Comprehensive Updated Systematic Review and Meta-Analysis Publisher Pubmed



Hallajzadeh J1, 2 ; Safiri S2, 3 ; Mansournia MA3 ; Khoramdad M4 ; Izadi N5 ; Almasihashiani A6 ; Pakzad R7 ; Ayubi E8 ; Sullman MJM9 ; Karamzad N10
Authors
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Authors Affiliations
  1. 1. Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Managerial Epidemiology Research Center, Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
  3. 3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Epidemiology and Biostatistics, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
  5. 5. Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Centre, Royan Institute for Reproductive Biomedicine, Tehran, Iran
  7. 7. Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
  8. 8. Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
  9. 9. Driving Research Group, Cranfield University, Bedfordshire, United Kingdom
  10. 10. Food and Drug, Maragheh University of Medical Sciences, Maragheh, Iran

Source: PLoS ONE Published:2017


Abstract

Background Estimating the current global prevalence of metabolic syndrome (MetS), and its components, among rheumatoid arthritis (RA) patients is necessary in order to formulate preventative strategies and to ensure there are adequate community resources available for these patients. Furthermore, the association between RA and MetS is controversial and has not previously been comprehensively assessed. Therefore, the present study aimed to: 1) determine the prevalence of MetS, and its components, among RA patients across the world 2) update the odds ratio of MetS in RA patients, compared to healthy controls, using a comprehensive systematic review and meta-analysis. Methods International databases, including: The Web of Science, PubMed, Scopus, Embase, CINAHL and other relevant databases were searched to identify English language articles which reported the prevalence and risk of MetS in RA patients between January 2000 and August 2016. The meta-analysis only included studies which clearly described the time and location of the study, utilised adequate sampling strategies, and appropriate statistical analyses. Results The meta-analyses of prevalence (70 studies [n = 12612]) and risk (43 studies [n = 35220]) of MetS in RA patients were undertaken separately. The overall pooled prevalence of MetS was 30.65% (95% CI: 27.87-33.43), but this varied from 14.32% (95% CI: 10.59-18.05) to 37.83% (95% CI: 31.05-44.61), based upon the diagnostic criteria used. The prevalence of MetS also varied slightly between males (31.94%, 95% CI: 24.37-39.51) and females (33.03%, 95% CI: 28.09-37.97), but this was not statistically significant. The overall pooled odds ratio (OR) of MetS in RA patients, compared to healthy controls, was 1.44 (95% CI: 1.20-1.74), but this ranged from 0.70 (95% CI: 0.27-1.76) to 4.09 (95% CI: 2.03-8.25), depending on the criteria used. The mean age and diagnostic criteria of MetS were identified as sources of heterogeneity in the estimated odds ratios between studies (P<0.05). Conclusions According to the high prevalence of MetS in RA patients, and high risk of MetS, measuring metabolic syndrome in RA patients is strongly recommended. Furthermore, as high waist circumference (WC) is the most common metabolic syndrome component, more attention must be paid to nutrition and weight loss among those with RA. © 2017 Hallajzadeh et al.This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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