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. 2023 Apr;50(4):526-531.
doi: 10.3899/jrheum.220610. Epub 2022 Dec 15.

Lower Frequency of Comorbidities Prior to Onset of Giant Cell Arteritis: A Population-Based Study

Mohanad Elfishawi  1 , Jigisha Rakholiya  2 , Tina M Gunderson  3 , Sara J Achenbach  3 , Cynthia S Crowson  4 , Eric L Matteson  4 , Carl Turesson  5 , Karin Wadström  6 , Cornelia Weyand  2 , Matthew J Koster  2 , Kenneth J Warrington  2
Affiliations

Lower Frequency of Comorbidities Prior to Onset of Giant Cell Arteritis: A Population-Based Study

Mohanad Elfishawi et al. J Rheumatol. 2023 Apr.

Abstract

Objective: To assess the frequency of comorbidities and metabolic risk factors at and prior to giant cell arteritis (GCA) diagnosis.

Methods: This is a retrospective case control study of patients with incident GCA between January 1, 2000, and December 31, 2019, in Olmsted County, Minnesota. Two age- and sex-matched controls were identified, and each assigned an index date corresponding to an incidence date of GCA. Medical records were manually abstracted for comorbidities and laboratory data at incidence date, 5 years, and 10 years prior to incidence date. Twenty-five chronic conditions using International Classification of Diseases, 9th revision, diagnosis codes were also studied at incidence date and 5 years prior to incidence date.

Results: One hundred and twenty-nine patients with GCA (74% female) and 253 controls were identified. At incidence date, the prevalence of diabetes mellitus (DM) was lower among patients with GCA (5% vs 17%; P = 0.001). At 5 years prior to incidence date, patients were less likely to have DM (2% vs 13%; P < 0.001) and hypertension (27% vs 45%; P = 0.002) and had a lower mean number (SD) of comorbidities (0.7 [1.0] vs 1.3 [1.4]; P < 0.001) compared to controls. Moreover, patients had significantly lower median fasting blood glucose (FBG; 96 mg/dL vs 104 mg/dL; P < 0.001) and BMI (25.8 vs 27.7; P = 0.02) compared to controls. Multivariable logistic regression analysis revealed negative associations for FBG with GCA at 5 and 10 years prior to diagnosis/index date.

Conclusion: DM prevalence and median FBG and BMI were lower in patients with GCA up to 5 years prior to diagnosis, suggesting that metabolic factors influence the risk of GCA.

Keywords: comorbidity; diabetes mellitus; epidemiology; giant cell arteritis; incidence; vasculitis.

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