Background: Axial spondyloarthritis (axSpA) is a chronic inflammatory condition with an increased risk of cardiovascular events. Diabetes is a well-established risk factor for cardiovascular disease and stroke. Multiple lines of evidence have suggested a connection between axSpA and diabetes due to inflammatory processes and shared risk factors¹.

Objectives: This study aimed to conduct a systematic review and meta-analyses to: (i) identify the prevalence of diabetes in axSpA and (ii) compare the risk of diabetes between axSpA and control populations.

Methods: A comprehensive literature search was conducted for articles published between 1 January 2000 and 15 November 2023 using Medline, Embase and Scopus. All observational studies reporting prevalence, incidence, or risk of diabetes in axSpA were included. Studies not published in English were excluded. Search results were independently screened by at least two reviewers, and data extracted into a proforma. A meta-analysis was performed using a random-effects model. The methodological quality of each included study was assessed using the JBI critical appraisal tool. The study protocol was registered in PROSPERO (CRD42023482573).

Results: In total, 2257 articles were identified, from which 23 studies were included for analysis amounting to a combined sample size of 65 025 patients. The pooled prevalence of diabetes in patients with axSpA was 7.0% (95% CI 5.0-8.0%) which was statistically significant (p=0.00). There was also a significantly higher odds of diabetes in patients with axSpA compared to controls (pooled OR 1.29, 95% CI 1.08-1.55). The funnel plot was symmetric, thereby indicating a low risk of publication bias.

Conclusion: Our findings indicate that the prevalence of diabetes in patients with axSpA is high. Routine screening for diabetes and lifestyle modifications should be encouraged in this population.

REFERENCES: [1] Hintenberger R, Affenzeller B, Vladychuk V, et al. Cardiovascular risk in axial spondyloarthritis-a systematic review. Clin Rheumatol 2023; 42: 2621–2633.

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Figure 1.

Pooled prevalence of diabetes in axial spondyloarthritis.

Acknowledgements: NIL.

Disclosure of Interests: Leher Gumber: None declared, Harini Samarasinghe: None declared, Praveen Gladston: None declared, Arumugam Moorthy Previously received speaker fee from Ellily, Galapagos and Novartis but not related to this project.