Review Prevalence of metabolic syndrome in primary antiphospholipid syndrome patients Gabriela Medina a , Ana Laura Gutiérrez-Moreno b , Olga Vera-Lastra c,e , Miguel A. Saavedra b , Luis J. Jara d,e, ⁎ a Clinical Research Unit, Hospital de Especialidades Centro Médico La Raza, IMSS, Mexico City, Mexico b Rheumatology Department, Hospital de Especialidades Centro Médico La Raza, IMSS, Mexico City, Mexico c Internal Medicine Department, Hospital de Especialidades Centro Médico La Raza, IMSS, Mexico City, Mexico d Direction of Education and Research, Hospital de Especialidades Centro Médico La Raza, IMSS, Mexico City, Mexico e Universidad Nacional Autónoma de México, Mexico City, Mexico abstract article info Article history: Received 17 September 2010 Accepted 5 October 2010 Available online 14 October 2010 Keywords: Metabolic syndrome Primary antiphospholipid syndrome Cardiovascular disease Objective: To estimate the prevalence of metabolic syndrome (MetS) in patients with primary antiphospholipid syndrome (PAPS). Patients and methods: Cross sectional study of PAPS patients from the outpatient clinic. MetS was based on three international definitions: World Health Organization (WHO), Adult Treatment Panel III (ATP III), or International Diabetes Federation (IDF). Clinical history and laboratory investigations, including insulin levels, lipid profile, glucose, and CRP, anthropometric and blood pressure measurements, were evaluated. Descriptive statistics was used. Kappa statistics examined the agreement between MetS definitions. Results: 58 PAPS patients were studied, mean age 42.14±11.62, 9 men, 49 women. The most frequent cardiovascular risk (CVR) factors were hypertriglyceridemia, low HDL cholesterol levels, and visceral obesity. Prevalence of MetS was 17.2% according to WHO, 34.5% according to ATP III and 37.9% according to IDF criteria. MetS according to ATP III and WHO criteria was similar to the general population (34.5% vs. 36.8%) (17.2% vs. 13.6%), and lower according to IDF definition (37.9% vs. 49.8%). Conclusions: This study shows a high prevalence of MetS in PAPS patients, similar to that in the general population and other autoimmune diseases. Identification of MetS is very important to indicate preventive strategies and reduce cardiovascular morbidity and mortality in PAPS. © 2010 Elsevier B.V. All rights reserved. Contents 1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 2. Patients and methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 2.1. Metabolic syndrome definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 2.2. Statistical analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 4. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216 Take-home messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 1. Introduction The antiphospholipid syndrome (APS), primary or associated is defined by the presence of antiphospholipid antibodies (aPL), pro- thrombotic state, and/ or pregnancy morbidity [1]. APS is a systemic condition involving almost any organ and tissue in the body [2]. Autoimmune rheumatic diseases including APS are associated with higher rates of cardiovascular disease (CVD), in part due to accelerated atherosclerosis. This phenomenon is the result of traditional cardiovas- cular risk factors, autoimmune, and inflammatory process among others [3,4]. The mechanisms for atherosclerosis in APS include functional and structural arterial abnormalities, reduction of nitric oxide bioavailability, paraoxonase activity, impaired anti-inflammatory and antioxidant properties, with low-grade inflammation and immune activation [5,6]. Metabolic syndrome (MetS) is a systemic proinflammatory state characterized by visceral adiposity, insulin resistance, low HDL Autoimmunity Reviews 10 (2011) 214–217 ⁎ Corresponding author. Hospital de Especialidades Centro Médico la Raza, Seris y Zaachila S/N Col. La Raza CP.02990 Mexico City, Mexico. Tel.: +52 5557245900x23015. E-mail address: luis_jara_quezada@hotmail.com (L.J. Jara). 1568-9972/$ – see front matter © 2010 Elsevier B.V. All rights reserved. doi:10.1016/j.autrev.2010.10.004 Contents lists available at ScienceDirect Autoimmunity Reviews journal homepage: www.elsevier.com/locate/autrev