Objectives Chronic inflammatory arthritis (CIA), including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS), is associated with elevated cardiovascular risk. Metabolic syndrome (MetS) is prevalent among these patients and may contribute to adverse clinical outcomes. This study aimed to investigate whether MetS independently predicts cardiovascular and all-cause adverse events in patients with CIA and to evaluate the dose–response relationship between the number of MetS components and prognosis. Method In this prospective observational study, 811 patients with CIA were enrolled between January 2016 and December 2020. Propensity score matching (PSM) was used to balance baseline covariates between patients with and without MetS. Primary and secondary endpoints were composite cardiovascular death/hospitalization and all-cause death/hospitalization, respectively. Cox proportional hazards regression models and Kaplan–Meier survival analyses were employed to evaluate the associations between MetS status and study outcomes. Results MetS was present in 35.0% of patients. During a median follow-up of 39 months, cardiovascular events occurred significantly more frequently in patients with MetS compared to those without (18.4% vs. 7.7%, p = 0.002). All-cause events were also higher in the MetS group (37.8% vs. 19.9%, p < 0.001). MetS independently predicted cardiovascular (adjusted HR = 4.12, 95% CI: 2.11–8.07, p < 0.001) and all-cause outcomes (adjusted HR = 2.81, 95% CI: 1.79–4.41, p < 0.001). Each additional MetS component was associated with a 1.68-fold increased risk of cardiovascular outcomes (95% CI: 1.24–2.51, p < 0.001). Conclusions MetS is an independent risk factor for cardiovascular and all-cause adverse outcomes in patients with CIA. <Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • MetS independently predicts both cardiovascular and all-cause adverse outcomes in patients with CIA after propensity score matching. • A dose–response relationship was identified, with each additional MetS component conferring higher cardiovascular risk. </entry> </row> </tbody> </tgroup> </Table>

Metabolic syndrome predicts cardiovascular and all-cause adverse outcomes in patients with chronic inflammatory arthritis

期刊论文
发表日期：

2026年4月20日

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Zhuoran Li,
Tingting Zou,
Yadong Li

摘要

Objectives

Chronic inflammatory arthritis (CIA), including rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS), is associated with elevated cardiovascular risk. Metabolic syndrome (MetS) is prevalent among these patients and may contribute to adverse clinical outcomes. This study aimed to investigate whether MetS independently predicts cardiovascular and all-cause adverse events in patients with CIA and to evaluate the dose–response relationship between the number of MetS components and prognosis.

Method

In this prospective observational study, 811 patients with CIA were enrolled between January 2016 and December 2020. Propensity score matching (PSM) was used to balance baseline covariates between patients with and without MetS. Primary and secondary endpoints were composite cardiovascular death/hospitalization and all-cause death/hospitalization, respectively. Cox proportional hazards regression models and Kaplan–Meier survival analyses were employed to evaluate the associations between MetS status and study outcomes.

Results

MetS was present in 35.0% of patients. During a median follow-up of 39 months, cardiovascular events occurred significantly more frequently in patients with MetS compared to those without (18.4% vs. 7.7%, p = 0.002). All-cause events were also higher in the MetS group (37.8% vs. 19.9%, p < 0.001). MetS independently predicted cardiovascular (adjusted HR = 4.12, 95% CI: 2.11–8.07, p < 0.001) and all-cause outcomes (adjusted HR = 2.81, 95% CI: 1.79–4.41, p < 0.001). Each additional MetS component was associated with a 1.68-fold increased risk of cardiovascular outcomes (95% CI: 1.24–2.51, p < 0.001).

Conclusions

MetS is an independent risk factor for cardiovascular and all-cause adverse outcomes in patients with CIA.

Key Points

• MetS independently predicts both cardiovascular and all-cause adverse outcomes in patients with CIA after propensity score matching.

• A dose–response relationship was identified, with each additional MetS component conferring higher cardiovascular risk.