THU0464B IS THERE AN ASSOCIATION BETWEEN METABOLIC SYNDROME AND SEVERITY OF HAND OSTEOARTHRITIS? RESULTS FROM A NATIONWIDE STUDY. (June 2019) - Cruz, Margarida
Abstract : Background: Hand osteoarthritis (HOA) is a highly prevalent rheumatic disease that predominates in females and causes pain, joint deformities and loss of functional capacity. Overweight and metabolic syndrome have been previously suggested to associate with the severity of HOA, but clarity on these associations is yet to be achieved. Objectives: To test the possible association between body mass index (BMI) and other individual components of metabolic syndrome with severity of HOA in females from a nationwide epidemiological study. Methods: EpiReumaPt was a three-stage national health survey where, in the first phase, 10, 661 adult participants were randomly selected and interviewed using a structured face-to-face questionnaire that included screening for rheumatic diseases, such as HOA. In the second phase, positive screenings for ≥1 rheumatic complaint plus 20% of the negative screenings were invited for an assessment by rheumatologists. Finally, 3 rheumatologists revised all the information and defined the final diagnosis by consensus. Female patients with a final clinical diagnosis of primary HOA were included in this analysis. Hand functional status as assed by the Cochin questionnaire was the outcome of interest. The explanatory variables of interest were: BMI evaluated as a categorical variable (Normal: 18-24.99; overweight: 25-29.99; obesity: ≥ 30), diabetes mellitus, hypertension and hypercholesterolemia (all self-reported and as binary variables: yes/no). The possible associations between BMI and the individual components of the metabolic syndrome with the Cochin score were tested in a multivariable linear regression model. Only significant variables (p<0, 05) were kept in the final model. Potential confounders of the associations of interest and the outcome were defined a priori on clinical grounds and included age and symptoms of depression (HADS score). Results: Out of the 3, 877 participants evaluated by Rheumatologists, 473 women had primary HOA (national prevalence: 6.6%). In this population, 40% were overweight and 29% were obese. Ninety-three (20%) participants had diabetes, 261 (56%) had hypertension and 261 (56%) had hypercholesterolemia. In the multiple regression model, BMI and diabetes were found to significantly associate with HOA severity, whereas hypertension and hypercholesterolemia did not, thus not being selected in the final model (table). Conclusion: In this study, higher BMI and the presence of diabetes mellitus associated with a worse functional capacity in women with primary HOA. These data add to the body of evidence suggesting a possible role of metabolic factors in the severity of HOA. References: [1] Yusuf E, Nelissen RG, Ioan-Facsinay A et al. Association between weight or body mass index and hand osteoarthritis: a systematic review. Ann Rheum Dis 2010. 69: 761-765 [2] Schett G, Kleyer A, Perricone C et al. Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care 2013; 36: 403-409 Acknowledgement: The authors thank all the participants of EpiReumaPt survey, the interviewers and staff and the Rheumatologists that worked in the field Disclosure of Interests: Margarida Cruz: None declared, Alexandre Sepriano: None declared, Sara Dias: None declared, Ana Maria Rodrigues: None declared, Helena Canhão: None declared, Nélia Gouveia: None declared, Mónica Eusébio: None declared, Sofia Ramiro Grant/research support from: MSD, Consultant for: AbbVie, Lilly, MSD, Novartis, Pfizer, Sanofi, Speakers bureau: AbbVie, Lilly, MSD, Novartis, Pfizer, Sanofi, Jaime Branco: None declared