Pará Research Medical Journal
http://prmjournal.org/article/doi/10.4322/prmj.2017.032
Pará Research Medical Journal
Artigo de Pesquisa Medicina

Ausência de influência da síndrome metabólica na atividade da artrite reumatóide

Absence of metabolic syndrome influence in rheumatoid arthritis activity

Breno Martins Farinazo, Mauro Marcelo Furtado Real Júnior, Cezar Augusto Muniz Caldas

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Resumo

Objetivo: Identificar a influência da Síndrome Metabólica (SM) na resposta ao tratamento dos pacientes portadores de Artrite Reumatoide (AR). Metodologia: Foi realizado um estudo do tipo transversal, descritivo e analítico, no período de setembro de 2013 a junho de 2014. A coleta de dados foi efetuada via protocolo de pesquisa elaborado pelos autores no ambulatório de Reumatologia do Centro de Especialidades Médicas (CEMEC) do Centro Universitário do Estado do Pará (CESUPA). Foram incluídos pacientes do sexo feminino, maiores de 18 anos e com diagnóstico de AR. Foram excluídos da pesquisa todos os pacientes tabagistas, com associação com outra doença autoimune, nefropatas, hepatopatas, mulheres gestantes, menopausadas e/ou em uso de contraceptivos hormonais. Resultados: Todas as pacientes (27) eram do sexo feminino, com média de idade de 40,89 ± 6,71anos e de tempo de doença de 7,67 ± 6,02anos, sendo que 21 pacientes (77,8%) apresentaram fator reumatóide positivo. Quanto à atividade da doença, a Velocidade de Hemossedimentação (VSH) apresentou média de 35,07 ± 17,43mm/h e a Proteína C Reativa (PCR) 13,85 ± 18,6mg/dl, respectivamente. A média do Disease Activity Score de 28 articulações (DAS28) foi de 4,69 ± 1,18. A frequência de SM encontrada entre os pacientes foi de 33,3% (n = 9). Em relação à atividade da doença mensurada pelo DAS28 (4,38 ± 0,74 vs. 4,84 ± 1,34, p = 0,263), VHS (33,44 ± 13,87mm/h vs. 35,94 ± 19,39mm/h, p = 0,709) e PCR (19,33 ± 26,66 mg/dl vs. 11,11 ± 13,07 mg/dl, p = 0,403), não houve diferença estatística entre os grupos com SM e sem SM (p=0,263). Conclusão: o presente estudo constatou que a presença de SM não influenciou na resposta ao tratamento nos pacientes com AR do CEMEC, não guardando relação com a atividade da doença, seja através de exames laboratoriais ou avaliada através do DAS28.

Palavras-chave

artrite reumatóide; síndrome metabólica; inflamação.

Abstract

Purpose: To identify the influence of Metabolic Syndrome (MS) in the response to treatment of patients with Rheumatoid Arthritis (RA). Methods: A cross-sectional, descriptive and analytical study was carried out from September 2013 to June 2014. Data collection was done through a research protocol developed by the authors at the ambulatory of Rheumatology of the Center of Medical Specialties (CEMEC) of the University Center of the State of Pará (CESUPA). We included female patients, older than 18 years and diagnosed with RA. All the smoking patients, with association with another autoimmune disease, nephropathy, hepatopathy, pregnant women, menopausal women and / or hormonal contraceptives were excluded from the study. Results:All the patients (27) were female, with a mean age of 40.89 ± 6.71 years and a disease time of 7.67 ± 6.02 years, with 21 patients (77.8%) presenting positive rheumatoid factor. Regarding the disease activity, the Erythrocyte Sedimentation Rate (ESR) presented a mean of 35.07 ± 17.43 mm / h and the C Rective Protein 13.85 ± 18.6 mg / dl, respectively. The mean Disease Activity Score of 28 joints was 4.69 ± 1.18. The frequency of MS found among patients was 33.3% (n = 9). In relation to the disease activity measured by DAS28 (4.38 ± 0.74 vs. 4.84 ± 1.34, p = 0.263), HSV (33.44 ± 13.87 mm / h vs. 35.94 ± 19, 39mm / h, p = 0.709) and CRP (19.33 ± 26.66 mg / dl vs. 11.11 ± 13.07 mg / dl, p = 0.403), there was no statistical difference between the SM and without MS (p = 0.263). Conclusion: The present study found that the presence of MS did not influence the response to treatment in patients with RA of CEMEC, not either related to disease activity, through laboratory tests or evaluated through the DAS28.

Keywords

rheumatoid arthritis; metabolic syndrome; inflammation.

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