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ElAdle SS, Latif EA, Abdel-Fattah YH, Shebini EE, El-Gazzar II, El-Saadany HM, Samy N, El-Mallah R, Salem MN, Eesa N, Shereef RE, El Khalifa M, Tharwat S, Nasef SI, Ibrahim ME, Khalil NM, Abdalla AM, Abd Elazeem MI, Noor RA, Sallam R, El-Bahnasawy A, Shanawany AE, Senara S, Fathi HM, Bakry SAE, Elsaman A, Najjar AE, Ragab U, Talaat EA, Hammam N, El-Hindawy AK, Gheita TA, Ismail F. Metabolic Syndrome in Behçets Disease Patients: Keep an Eye on the Eye. Curr Rheumatol Rev 2023; 19:180-188. [PMID: 35692166 DOI: 10.2174/1573397118666220610123242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is characterized by insulin resistance, high blood pressure/ sugar, dyslipidemia, and obesity. Whether MetS and its components affect the development of Behçet's Disease (BD) remains unclear. AIMS The aim was to determine the frequency of MetS among BD patients and to study its relationship with disease characteristics. METHODS The study included 1028 adult BD patients recruited from 18 specialized rheumatology centers. 51 healthy matched control were considered. Behçet Disease Current Activity Form (BDCAF) and the BD damage index (BDI) were estimated. Adult Treatment Panel-III criteria were used to define MetS. RESULTS The mean age of patients was 36.8 ± 10.1 years, M:F 2.7:1 and disease duration 7.01 ± 5.2 years. Their mean BDCAF was 5.1 ± 4.6 and BDI 5.5 ± 2.8. MetS was present in 22.8% of patients and in 5.9% of control (3.9 fold higher-risk). Patients with MetS had a significantly increased age at onset (31.8 ± 9.2 vs. 29 ± 8.5 years) and higher frequency of genital ulcers (96.2% vs. 79.7%), skin involvement (73.1% vs. 50.4%), arthritis (48.3% vs. 29.1%) (p<0.0001) and CNS manifestations (18.8% vs. 13%) (p=0.042) compared to those without it. Eye involvement was significantly increased in those with MetS (82.1% vs. 74.2%) (p=0.003) with increased frequency of posterior uveitis (67.1% vs. 43.5%), retinal vessel occlusion (35.9% vs. 21.3%), retinal vasculitis (41.9% vs. 26.4%) (p<0.0001) and vitritis (37.2% vs. 24%) (p=0.001). BDCAF was significantly lower (3.9 ± 4.3 vs. 5.6 ± 4.6) and BDI higher (7.4 ± 2.7vs5 ± 2.6) (p<0.0001). CONCLUSION BD patients with MetS are predisposed to mucocutaneous, musculoskeletal, neuropsychiatric and ocular manifestations with consequently increased damage. The involvement of the deeper structures of the eye should alarm rheumatologists to keep in mind that all patients should have an eye examination, especially those with MetS.
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Affiliation(s)
- Suzan S ElAdle
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eiman Abdel Latif
- Ophthalmology Department, Faculty of Medicine, Alexandria University, Egypt
| | - Yousra H Abdel-Fattah
- Rheumatology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Emad El Shebini
- Internal Medicine Department, Rheumatology Unit, Menoufia University, Menoufia, Egypt
| | - Iman I El-Gazzar
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hanan M El-Saadany
- Rheumatology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Nermeen Samy
- Internal Medicine Department, Faculty of Medicine, Rheumatology Unit, Ain-Shams University, Cairo, Egypt
| | - Reem El-Mallah
- Rheumatology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed N Salem
- Internal Medicine Department, Faculty of Medicine, Rheumatology Unit, Beni-Suef University, Beni-Suef, Egypt
| | - Nahla Eesa
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Rawhya El Shereef
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
| | - Marwa El Khalifa
- Internal Medicine Department, Rheumatology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samar Tharwat
- Internal Medicine Department, Faculty of Medicine, Mansoura University, Rheumatology Unit, Dakahlia, Egypt
| | - Samah I Nasef
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Maha Emad Ibrahim
- Rheumatology Department, Faculty of Medicine, Suez-Canal University, Ismailia, Egypt
| | - Noha M Khalil
- Internal Medicine Department, Faculty of Medicine, Cairo University, Rheumatology Unit, Cairo, Egypt
| | - Ahmed M Abdalla
- Rheumatology Department, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Mervat I Abd Elazeem
- Rheumatology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Rasha Abdel Noor
- Internal Medicine Department, Rheumatology Unit, Tanta University, Gharbia, Egypt
| | - Rehab Sallam
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Amany El-Bahnasawy
- Rheumatology Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt
| | - Amira El Shanawany
- Rheumatology Department, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Soha Senara
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Hanan M Fathi
- Rheumatology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt
| | - Samah A El Bakry
- Internal Medicine Department, Faculty of Medicine, Rheumatology Unit, Ain-Shams University, Cairo, Egypt
| | - Ahmed Elsaman
- Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amany El Najjar
- Rheumatology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt
| | - Usama Ragab
- Internal Medicine Department, Clinical Immunology Unit, Zagazig University, Sharkia, Egypt
| | - Esraa A Talaat
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nevin Hammam
- Rheumatology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Aya K El-Hindawy
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Tamer A Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Faten Ismail
- Rheumatology Department, Faculty of Medicine, Minia University, Minia, Egypt
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