An Analysis of Metabolic Syndrome in Adult Dermatomyositis with a Focus On Cardiovascular Disease

Abstract

Background/Purpose: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities associated with increased cardiovascular risk. MetS has been systematically evaluated in all systemic autoimmune rheumatic diseases except for dermatomyositis (DM). Hence, we evaluated the frequency of MetS in DM patients and analyzed the possible association of MetS with traditional cardiovascular disease (CVD) risk factors and DM-related clinical and laboratorial features. Methods: The present cross-sectional single center study included 84 consecutive DM patients (Bohan & Peter, 1975) and 105 healthy control individuals. MetS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III. Results: The median age was similar in both the DM and control groups (aged 41.5 vs. aged 42.0, respectively; p=0.378) with a comparable predominance of the female gender (p=0.904) and white race (p=0.654) in both groups. The median disease duration was 4 years (range: 1–7). The DM patients had a higher prevalence of MetS (41.7 vs. 7.0%, p<0.001), diabetes mellitus (17.9 vs. 1.0%, p<0.001), ischemic stroke (4.8 vs. 0%, p=0.024), and a family history of premature CVD (32.8 vs. 8.6%, p=0.004). However, the frequency of sedentarism, hypothyroidism, smoking habit and alcohol intake were similar in both groups (p>0.05). Further analysis of the DM patients with (n=35) and without MetS (n=49) revealed that the patients with this complication were older (50.0±14.5 vs. 40.9±14.6, p=0.006) and had a similar disease duration (p=0.925) and a higher incidence of systemic arterial hypertension prior to the disease (54.3 vs. 10.2%, p=0.001). The frequency of other comorbidities, previously mentioned lifestyle contributing factors, clinical and laboratory disease features, and therapy schemes were similar in both groups (p>0.05). In a multivariate analysis, only hypertension diagnosed prior to the disease was associated with MetS (odds ratio 10.47, 95% confidence interval 2.62–44.81). Conclusion: MetS is highly prevalent in DM and prior hypertension seems to be a major determinant of its development while disease and therapy related factors do not appear to play a relevant role.