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

Mohanad Elfishawi, Jigisha Rakholiya, Tina M. Gunderson, Sara J. Achenbach, Cynthia S. Crowson, Eric L. Matteson, Carl Turesson, Karin Wadström, Cornelia Weyand, Matthew J. Koster, Kenneth J. Warrington

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)526-531
Number of pages6
JournalJournal of Rheumatology
Issue number4
StatePublished - 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 The Journal of Rheumatology.


  • comorbidity
  • diabetes mellitus
  • epidemiology
  • giant cell arteritis
  • incidence
  • vasculitis


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