Prevalence of metabolic syndrome in Algerian rheumatoid arthritis patients. Correlation with disease activity and functional status.

BACKGROUND: There is evidence that rheumatoid arthritis (RA) patients have an over-risk of cardiovascular disease. This may be mainly due to an increase in the prevalence of metabolic syndrome (MetS). The prevalence of MetS among adults in Algeria is 19.1%. OBJECTIVES: The aim of the study was to evaluate the prevalence of MetS among RA patients in Algeria. Another aim was to evaluate the relationship between MetS, inflammation biomarkers and disease scores. METHODS: The study was performed on a cohort of 249 patients meeting the ACR/EULAR criteria for RA, followed in 11 Algerian centers. The diagnosis of MetS was based on the NCEP/ATP III (MetS+ if ≥3/5) definition. Prevalence of MetS was calculated, and patients were divided in two groups (MetS+ and MetS-). Comparison between the groups was performed using a t-test. RESULTS: Among the 249 RA patients, 213 were females and 36 males of a mean age of 50.1±14.5years and a mean disease duration of 8.4±7.8years. The overall prevalence of MetS was 13.9% (CI95%: 9.5-20.1%); it was 14.3% in males and 13.8% in females. The ESR level was significantly higher in MetS+ patients than in MetS- patients (p=0.036). CONCLUSION: In this multicenter study, unlike most studies on RA patients, the prevalence of MetS was as not higher in Algerian RA patients (13.9%) than in the Algerian general population (19.1%). Only ESR levels correlate with the presence of MetS, this may be due to the modest cohort size and needs to be confirmed.

Characteristics of rheumatoid arthritis in Algeria: a multicenter study.

The aim of this study was to compare the epidemiology of rheumatoid arthritis (RA) in North Africa to that of Western countries. We have enrolled in a cross-sectional study all consecutive patients presenting with the diagnosis of RA according to the 1987 ACR criteria, and during a 5-month period, patients were included in 11 centers across northern Algeria. Demographics, clinical data, and health assessment questionnaires (HAQ) were collected for each patient. We have estimated means, standard deviations, and 95 % confidence intervals for all parameters. Of the 249 patients (213 females and 36 males) enrolled in the study, 10 (4 %) had juvenile onset of the disease. The mean age was 50.1 ± 14.5 years, and the mean duration of RA was 8.4 ± 7.8 years. In terms of comorbidities, 18.9 % of patients reported hypertension and 5.2 % had diabetes. The mean DAS28 at inclusion was 4.3 (95 % CI 4.1-4.5); 14.0 % were in remission (DAS28 ≤ 2.6). The mean HAQ score was 0.81 ± 0.82. Rheumatoid factor was positive in 78.5 % of cases, and anti-citrullinated protein/peptide antibodies, when measured, was positive in 69.0 % of cases. Seronegative patients were older and had a relatively less severe disease. For treatment, 89.7 % of patients were taking disease-modifying anti-rheumatic drugs and only 4 % were taking biologics (rituximab); 90.8 % of patients were taking glucocorticoids, and none of the patients satisfied the recommended calcium intake guidelines. RA in Algeria is more common in women. Compared to reports from Western countries, RA in Algeria appears to be less aggressive, with more dominant seronegative oligoarthritis forms. The remission rate is comparable to that of Western populations.