Metabolic syndrome and cardiovascular-kidney-metabolic health: Evaluation of predictive risk factor for mortality in systemic sclerosis

Background and aims: Few studies have addressed the MetS in systemic sclerosis (SSc) patients. Several classifications have been proposed to define metabolic syndrome (MetS). The aim of the study was to evaluate if MetS and cardiovascular-kidney-metabolic health assessment may predict mortality in SSc patients during a 10-year follow-up. Methods and results: Ninety consecutive SSc patients were enrolled. The diagnosis of MetS was made according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP-III), NCEP-R, International Diabetes Federation (IDF) and cardiovascular-kidney-metabolic syndrome (CKM) classification. Mortality was observed in 21 (23.3 %) SSc patients. Kaplan-Meier curves showed that overall survival probability was shorter in patients with MetS according to NCEP-ATPIII (p < 0.001), NCEP-R (p < 0.05) and IDF (p < 0.05) compared to patients without MetS; while the overall survival was similar in patients with CKM 0–1 and patients with CKM 2-3-4. Cumulative incidence rate of SSc-related death was similar in patients with MetS according to NCEP-ATPIII, NCEP-R and IDF compared to patients without MetS and in patients with CKM 0–1 and patients with CKM 2-3-4. Cumulative incidence rate for all-cause mortality not-SSc related was higher in patients with MetS according to NCEP-ATPIII (p < 0.001), NCEP-R (p < 0.01) and IDF (p < 0.01) compared to patients without MetS; while the cumulative incidence rate all-cause mortality not-SSc related was similar in patients with CKM 0–1 and patients with CKM 2-3-4. Conclusions: MetS is a risk factor for all-cause mortality in SSc patients but not related to underlying disease.