Association between cardiovascular risk factors and the occurrence of giant cell arteritis: a systematic review and meta-analysis.

Abstract

We aimed to analyse the association between cardiovascular risks factors and the onset of GCA through a systematic review and meta-analysis of observational studies. Three databases (Medline, Embase, Web of Science) were systematically reviewed. Epidemiological studies on the association between six cardiovascular risk factors (type 2 diabetes, hypertension, dyslipidaemia, smoking, overweight/obesity, history of a cardiovascular disease) and the risk of GCA were eligible. Risk of bias was assessed using the ROBINS-E scale. Pooled associations for studies assessing the same outcome were reported as odds ratios (ORs) with their 95% CIs. The search strategy identified 4210 references, of which 43 studies were analysed and 17 were included in the meta-analysis (11 case-control studies, 4 cohort studies and 2 cross-sectional studies). An inverse association was found between type 2 diabetes and risk of GCA (OR = 0.75, 95% CI 0.61-0.93), whereas history of cardiovascular disease was positively associated with risk of GCA (OR = 1.28, 95% CI 1.18-1.38). In addition, the analysis identified a trend towards a decreased risk of GCA in overweight participants (OR 0.64; 95% CI 0.41-1.00). Our study showed an inverse association between type 2 diabetes and risk of GCA, and a positive association between a history of cardiovascular disease and risk of GCA. It also identified a trend towards an inverse association between overweight and risk of GCA. The pathophysiological mechanisms underlying these findings may involve an effect of cardiovascular risk factors themselves, a condition underlying these factors (such as diet), or a condition following the diagnosis of cardiovascular disease (such as a treatment).