Cardiovascular and metabolic risk factors in inherited auto inflammation

Gilad Twig, Avi Livneh, Asaf Vivante, Arnon Afek, Estela Derazne, Adi Leiba, Dana Ben Ami Shor, Chanan Meydan, Ilan Ben-Zvi, Dorit Tzur, Ariel Furer, Massimo Imazio, Yehuda Adler, Howard Amital

Research output: Contribution to journalArticlepeer-review


Results; In multivariable regression analysis adjusted for known confounders of obesity, FMF participants had an odds ratio of 0.65 forthe occurrence of overweight [95% confidence interval (CI) 0.44-0.96, P=.03] and 0.66 (95% CI 0.48-0.92, P =.012) for hypertension-range BP; their siblings tended to obesity (odds ratio 1.48; 95% CI1.04-2.11, P=.008). In thefollow-up arm, a multivariable analysis adjusted for age, birthyear, BMI, education, socioeconomicstatus, ethnicity, and physical activityyielded hazard ratios of 0.32 (95% CI 0.10-0.82, P=.002) for incident obesity, 0.49(95% CI 0.25-0.95, P=.037) for incident triglycerides 150 mg/dL or greater, 0.56 (95% CI 0.31-0.98, P =.048) for low-density lipoprotein cholesterol 130 mg/dL or greater, and 2.14(1.368-3.359, P=.001) for high-density lipoprotein cholesterol less than 40 mg/dL for FMF participants compared with controls. Incident elevated BP was lower among FMF participants (hazard ratio 0.49; 95% CI 0.23-1.00, P =.05), where as dysglycemia incidence was comparable.

Conclusions: FMFis associated with lower rates of most components of the metabolicsyndrome compared with normal subjects, unlike other inflammatory conditions.

Context: The natural progression of metabolic abnormalities among patients with inherited auto inflammation is unclear.

Objective: The objective of the study was to assess the cardiometabolic risk of participants with familial Mediterranean fever (FMF).

Design and Setting: This study included nationwide cross-sectional and longitudinal cohorts.

Participants: The prevalence of components of the metabolic syndrome at age 17 years was assessed from the medical database of the Israeli Defense Force from 1973 through 1997. Included were 745 males with FMF, 902 healthy male siblings, and a control group of 787 714 participants. A prospective follow-up study traced the incidence of components of the metabolic syndrome to age 45 years among 57 FMF and 1568 control army personnel participants.

Interventions: Body mass index (BMI) and blood pressure (BP) were measured at age 17 years (crosssectional); lifestyle, anthropometric, and biochemical data were periodically recorded from age 25 years.

Main Outcome Measures: Abnormal BMI or BP (age 17y) and Adult Treatment Panel III criteria of the metabolic syndrome were measured.

Original languageEnglish
Pages (from-to)E2123-E2128
JournalJournal of Clinical Endocrinology and Metabolism
Issue number10
StatePublished - 1 Oct 2014
Externally publishedYes


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