- Original article
- Open access
- Published:
Association between microalbuminuria and metabolic syndrome in patients with rheumatoid arthritis
Egyptian Rheumatology and Rehabilitation volume 45, pages 87–93 (2018)
Abstract
Context
Rheumatoid arthritis (RA) is an autoimmune, symmetrical polyarticular disease characterized by chronic inflammation of the synovial joints. Microalbuminuria (MA) occurs as leakage of small amounts of albumin into the urine. Metabolic syndrome (MetS) describes the risk factors for cardiovascular diseases such as dyslipidemia, obesity, hypertension, and diabetes.
Aim
The aim of this study was to detect the prevalence of MA in patients with RA and study its correlation with disease activity and severity. Our aim extends to identify the association of MA with MetS in RA.
Patients and methods
This study was carried out on 30 adult RA patients, 30% of them were men and 70% were women (mean±SD: 42.27±10.99 years). Their mean disease duration was 12.8±7.06 years. A total of 20 apparently healthy adults, age-matched and sex-matched served as a control group. All the patients were subjected to full history taking, full clinical examination, laboratory investigations, and assessment of disease activity using the disease activity score for 28joints score. Urinary microalbumin level was measured in all participants in early morning samples by the immunoturbidometry method. MetS was assessed in all participants according to Grundy’s criteria.
Results
The frequency of MetS was highly statistically significant in patients with RA compared with the control group. The RA patients’ group had highly significantly elevated mean values of urinary microalbumin and urinary albumin to creatinine ratio compared with the control group.
Conclusion
MA and MetS are frequent in RA, particularly in those with long-standing disease. Early detection of albuminuria allows early intervention with the goal of reducing inflammation development in RA, cardiovascular risk. MetS is frequent in RA patients with MA.
References
Ramesh BN, Mahalakshmi AM. Present clinical approaches to rheumatoid arthritis: an ample review. Indo Am J Pharma Sci 2013; 3:6055–6065
American Diabetes Association. Nephropathy in diabetes. J Diabetes Care 2004; 27(Suppl 1):79–83
Bhatt G, Mathur DS, Saxena GN, Bhanadari S. Microalbuminuria in rheumatoid arthritis: a correlation with disease activity. J Assoc Physicians India 2002; 50:82
Lars MP, Henrik N, Birthe S, Henning B. Microalbuminuria in patients with rheumatoid arthritis. Ann Rheum Dis 1995; 54:189–192
Stamatelopoulos KS, Kitas GD, Papamichael CM, Chryssohoou E, Kyrkou K, Georgiopoulos G, et al. Atherosclerosis in rheumatoid arthritis versus diabetes: a comparative study. Arterioscler Thromb Vasc Biol 2009; 29:1702–1708
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112:e285–e290
Nidavani RB, Mahalakshmi AM, Patil JS. Microalbuminuria as risk indicator in rheumatoid arthritis: an updated review. Int J Pharm Clin Res 2014; 6:138–145
Sihvonen S, Korpela M, Mustonen J, Laippala P, Pastemack A. Renal disease as a predictor of increased mortality among patients with rheumatoid arthritis. Nephron Clin Pract 2004; 96:c107–c114
Cynthia CS, Silvia R, George D, Sherine E, Gabriel SE, et al. Challenge of developing a cardiovascular risk calculator for patients with rheumatoid arthritis. PLoS One 2017; 12:e0175605
Pederson LM, Nordin H, Svensson B, Bliddal H. Microalbuminuria in patients with rheumatoid arthritis. Ann Rheum Dis 1995; 54:189–192
Mpofu S, Kaushik VV, Grundy G,Moots RJ. Microalbuminuria: it is a predictor of ischemic heart disease in rheumatoid arthritis. Rheumatology (Oxford) 2004; 43:537–538
Dimitrios D, Vasileios F, Panoulas VF, Ioannis A. Microalbuminuria in rheumatoid arthritis in the post penicillamine/gold era. Clin Rheumatol 2011; 30:477–484
Hillege HL, Fidler V, Diercks GF, van Gilst WH, de Zeeuw D, van Veldhuisen DJ, et al. Urinary albumin excretion predicts cardiovascular and noncardiovascular mortality in general population. Circulation 2002; 106:1777–1782
Jensen JS, Clausen P, Borch K, Jensen G. Detecting microalbuminuria by urinary albumin/creatinine concentration ratio. Nephrol Dial Transplant 1997; 12:6–9
Dawnay A, Wilson AG, Lamb E, Kirby JD, Cattell WR. Microalbuminuria in systemic sclerosis. Ann Rheum Dis 1992; 51:384–388
Gremese E, Ferraccioli G. The metabolic syndrome: the crossroads between rheumatoid arthritis and cardiovascular risk. Autoimmun Rev 2011; 10:582–589
Chung CP, Oeser A, Solus JF. Inflammation- associated insulin resistance: differential effects in rheumatoid arthritis and systemic lupus erythematosus define potential mechanisms. Arthritis Rheum 2008; 58:2105–2112
Karvounaris SA, Sidiropoulos PI, Papadakis JA, Spanakis EK, Bertsias GK, Kritikos HD, et al. Metabolic syndrome is common among middle-to-older aged Mediterranean patients with rheumatoid arthritis and correlates with disease activity: a retrospective, cross-sectional, controlled, study. Ann Rheum Dis 2007; 66:28–33
Sahebari M, Goshayeshi L, Mirfeizi Z, Rezaieyazdi Z, Hatef MR, Ghayour-Mobarhan M, et al. Investigation of the association between metabolic syndrome and disease activity in rheumatoid arthritis. Scientific World Journal 2011; 11:1195–1205
Toms TE, Panoulas VF, Douglas KM, Griffiths HR. Lack of association between glucocorticoid use and presence of the metabolic syndrome with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2009; 10: R145
Dessein PH, Norton GR, Joffe BI, Abdool-Carrim AT, Woodiwiss AJ, Solomon A. Metabolic cardiovascular risk burden and atherosclerosis in African black and Caucasian women with rheumatoid arthritis: a cross-sectional study. Clin Exp Rheumatol 2013; 31:53–61
Dao HH, Do QT, Sakamoto J. Increased frequency of metabolic syndrome among Vietnamese women with early rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2010; 12:R218
Chakib N, Fatima A, Samia M, Adil N, Latifa T, Taoufik H. Prevalence of metabolic syndrome in patients with rheumatoid arthritis in Morocco: a cross-sectional study. Clin Rheumatol 2014; 33:1549–1555
Toms TE, Panoulas VF, Douglas KM, Griffiths HR, Kitas GD. Lack of association between glucocorticoid use and presence of the metabolic syndrome in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2008; 10:R145
Cirillo M, Senigalliesi L, Laurenzi M, Alfieri R, Stamler J, Stamler R, et al. Microalbuminuria in nondiabetic adults: relation of blood pressure, body mass index, plasma cholesterol levels, and smoking. Arch Intern Med 1998; 158:1933–1939
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Abdelmonem, S., Eltanawy, R., Ismail, Y. et al. Association between microalbuminuria and metabolic syndrome in patients with rheumatoid arthritis. Egypt Rheumatol Rehabil 45, 87–93 (2018). https://doi.org/10.4103/err.err_37_17
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/err.err_37_17