Higher Prevalence and Degree of Insulin Resistance in Patients With Rheumatoid Arthritis Than in Patients With Systemic Lupus Erythematosus

Quevedo-Abeledo, Juan Carlos; Sánchez-Pérez, Hiurma; Tejera-Segura, Beatriz; Armas-Rillo, Laura de; Ojeda, Soledad; Erausquin, Celia; Ferraz-Amaro, Iván

doi:10.3899/jrheum.200435

Cited by 15 publications

(9 citation statements)

References 31 publications

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“…In SLE patients, the Quantose algorithm for IR correlated with other IR surrogates and levels of complement C. However, no other associa tions between the Quantose IR score (or its metabolites) and SLE disease indicators, including vitamin D levels were identified. Several studies have determined the prevalence of IR in patients with SLE, finding a range of 14 % to 48 %, and compared it with that of controls [24][25][26][27]. Most of these analyses were performed using the HOMA model; in our study, the prevalence of IR was 39.1 % and 42.2 % using HOMA1IR and HOMA2IR, respectively.…”

Section: Discussionmentioning

confidence: 67%

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Metabolomic Profile of Insulin Resistance Women with Systemic Lupus Erythematosus

et al. 2023

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The aims of this study were in systemic lupus erythematosus (SLE) patients: 1) to compare the metabolomic profile of insulin resistance (IR) with controls and 2) to correlate the metabolomic profile with other IR surrogates and SLE disease variables and vitamin levels. In this cross-sectional study, serum samples were collected from women with SLE (n= 64) and gender- and age-matched controls (n= 71), which were not diabetic. Serum metabolomic profiling was performed using UPLC-MS-MS (Quantse score). HOMA and QUICKI were carried out. Serum 25(OH)D concentrations were measured by chemiluminescent immunoassay. In women with SLE, the metabolomic Quantose score significantly correlated with HOMA-IR, HOMA2-IR, and QUICKI. Although concentrations of IR metabolites were not different between SLE patients and controls, fasting plasma insulin levels were higher and insulin sensitivity lower in SLE women. Interestingly, the Quantose IR score was significantly correlated with complement C3 levels (r= 0.7; p= 0.001). 25 (OH)D did not correlate with any metabolite or the Quantose IR index. Quantose IR may be a useful tool for IR assessment. There was a possible correlation between the metabolomic profile and complement C3 levels. The implementation of this metabolic strategy may help develop biochemical insight into metabolic disorders in SLE.

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Section: Discussionmentioning

confidence: 67%

“…Several studies have determined the prevalence of IR in patients with SLE, finding a range of 14% to 48%, and compared it with that of controls 24 25 26 27 . Most of these analyses were performed using the HOMA model; in our study, the prevalence of IR was 39.1% and 42.2% using HOMA1-IR and HOMA2-IR, respectively.…”

Section: Discussionmentioning

confidence: 99%

Metabolomic Profile of Insulin Resistance Women with Systemic Lupus Erythematosus

et al. 2023

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“…Избыточный вес и ожирение являются факторами риска ИР и МС. Частота ИР у больных СКВ составляет 14-49,1% [18][19][20][21][22][23], МС -3,3-45,2% [24], а ожирения -28-50% [2][3][4].…”

Section: Discussionunclassified

Obesity and overweight phenotypes in patients with systemic lupus erythematosus based on body mass index and serum leptin levels: a pilot cross-sectional study

Kondratyeva¹,

Попкова²,

Panafidina³

et al. 2022

Naučno-praktičeskaâ revmatologiâ

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Objective – to identify obesity/overweight phenotypes in patients with systemic lupus erythematosus (SLE) based on the body mass index (BMI) and serum leptin levels assessment, and to clarify the relationship of these phenotypes with different metabolic disorders.Material and methods. The study included 51 patients with SLE (48 women, 3 men) without diabetes mellitus. The median age of patients was 40 [31; 48] years, disease duration was 3.0 [0.6; 9.0] years. Glucocorticoids were received by 84% of patients, hydroxychloroquine – by 76%, immunosuppressants – by 20%, biological agents – by 10%. BMI was calculated and the fasting leptin level in serum was determined (ELISA) in all patients. Leptin concentrations >11.1 ng/ml in women and >5.6 ng/ml in men corresponded to hyperleptinaemia. There were three main obesity/overweight phenotypes: “classic” (BMI≥25 kg/m2 + hyperleptinemia), “healthy” (BMI≥25 kg/m2 , without hyperleptinemia), “hidden” or “latent” (BMI<25 kg/m2 + hyperleptinemia), as well as “normal weight” (BMI><25 kg/m2 , without hyperleptinemia).>˂ 25 kg/m2 + hyperleptinemia), as well as “normal weight” (BMI˂ 25 kg/m2 , without hyperleptinemia).Results. The “classic” phenotype of obesity/overweight was diagnosed in 22 (43%) patients, the “healthy” – in 1 (2%), the “hidden” – in 14 (27.5%) patients with SLE. Insulin concentrations were: 10.0 [7.5; 17.9] μU/mL in the “classic” phenotype, 8.3 [6.0; 11.9] μU/mL in the “hidden” phenotype, and 5.3 [4.2; 6.3] μU/ml at “normal weight” (p=0.001). HOMA-IR index were: 2.18 [1.70; 4.23], 1.78 [1.23; 2.41] and 1.18 [0.95; 1.52], respectively (p=0.002). The levels of glucose, total cholesterol, ApoB did not differ in the groups. The uric acid concentrations were the highest in the “classic” phenotype group (334 [365; 388] μmol/l), the lowest in the group of “hidden” obesity/overweight (257 [214; 296] μmol/l), and intermediate in “normal weight” group (286 [236; 377] μmol/l) (p=0.04).Conclusion. The majority of SLE patients hade the “classic” obesity/overweight phenotype, while the “healthy” phenotype was extremely rare. In 27.5% of patients, the presence of a “latent” phenotype was confirmed, which, in terms of metabolic disorders, is an intermediate stage between “normal weight” and “classic” obesity. For rational and timely prevention of insulin resistance, metabolic syndrome and related complications, it is necessary to actively identify the “hidden” phenotype.

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“…Rheumatoid arthritis (RA) is a systemic autoimmune disease associated with a high prevalence of insulin resistance [ 1 , 2 ], a known risk factor for cardiovascular disease and type 2 diabetes [ 3 ]. Several studies have reported that insulin resistance in RA is associated with systemic inflammation, rheumatoid factor and anti-citrullinated protein antibodies (ACPA) seropositivity, obesity, and glucocorticoid use [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Association between skeletal muscle mitochondrial dysfunction and insulin resistance in patients with rheumatoid arthritis: a case–control study

et al. 2023

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Background Insulin resistance affects a substantial proportion of patients with rheumatoid arthritis (RA). Skeletal muscle mitochondrial dysfunction results in the accumulation of lipid intermediates that interfere with insulin signaling. We therefore sought to determine if lower oxidative phosphorylation and muscle mitochondrial content are associated with insulin resistance in patients with RA. Methods This was a cross-sectional prospective study of RA patients. Matsuda index from the glucose tolerance test was used to estimate insulin sensitivity. Mitochondrial content was measured by citrate synthase (CS) activity in snap-frozen muscle samples. Mitochondrial function was measured by using high-resolution respirometry of permeabilized muscle fibers and electron transport chain complex IV enzyme kinetics in isolated mitochondrial subpopulations. Results RA participants demonstrated lower insulin sensitivity as measured by the Matsuda index compared to controls [median 3.95 IQR (2.33, 5.64) vs. 7.17 (5.83, 7.75), p = 0.02]. There was lower muscle mitochondrial content among RA vs. controls [median 60 mU/mg IQR (45, 80) vs. 79 mU/mg (65, 97), p = 0.03]. Notably, OxPhos normalized to mitochondrial content was higher among RA vs. controls [mean difference (95% CI) = 0.14 (0.02, 0.26), p = 0.03], indicating a possible compensatory mechanism for lower mitochondrial content or lipid overload. Among RA participants, the activity of muscle CS activity was not correlated with the Matsuda index (ρ = − 0.05, p = 0.84), but it was positively correlated with self-reported (IPAQ) total MET-minutes/week (ρ = 0.44, p = 0.03) and Actigraph-measured time on physical activity (MET rate) (ρ = 0.47, p = 0.03). Conclusions Mitochondrial content and function were not associated with insulin sensitivity among participants with RA. However, our study demonstrates a significant association between muscle mitochondrial content and physical activity level, highlighting the potential for future exercise interventions that enhance mitochondrial efficiency in RA patients.

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Higher Prevalence and Degree of Insulin Resistance in Patients With Rheumatoid Arthritis Than in Patients With Systemic Lupus Erythematosus

Cited by 15 publications

References 31 publications

Metabolomic Profile of Insulin Resistance Women with Systemic Lupus Erythematosus

Metabolomic Profile of Insulin Resistance Women with Systemic Lupus Erythematosus

Obesity and overweight phenotypes in patients with systemic lupus erythematosus based on body mass index and serum leptin levels: a pilot cross-sectional study

Association between skeletal muscle mitochondrial dysfunction and insulin resistance in patients with rheumatoid arthritis: a case–control study

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