Insulin resistance and adverse lipid profile in untreated very early rheumatoid arthritis patients: A single-center, cross-sectional study in China

Abstract

Objectives: This study aims to evaluate the presence and factors related to insulin resistance (IR) in untreated very early rheumatoid arthritis (RA) patients. Patients and methods: Between June 2020 and July 2021, a total of 90 RA patients (29 males, 61 females; mean age: 49.3±10.2 years; range 24 to 68 years) and 90 age-, sex- and body mass index (BMI)-matched controls (35 males, 55 females; mean age: 48.3±5.1 years; range 38 to 62 years) were included. Homeostatic model assessment was applied to evaluate IR (HOMA-IR) and β-cell function (HOMA-β). Disease activity score 28 (DAS28) was used to estimate disease activity. Lipid profile, hemoglobin A1c (HbA1c), glucose, insulin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were measured. Logistic regression analysis was performed to investigate the relationship between the IR and clinical features of RA patients. Results: The RA patients had higher HOMA-IR values (p<0.001) and adverse lipid profile. The IR was positively correlated with age (r=0.35, p<0.01), CRP (r=0.42, p<0.001), ESR (r=0.33, p<0.01), disease duration (r=0.28, p<0.01), and DAS28 (r=0.50, p<0.001). The DAS28, CRP and age, but not sex and menopausal status, were independently associated with IR. Conclusion: Insulin resistance was present in untreated very early RA patients. The DAS28, CRP, and age were independent predictors for the presence of IR. Based on these findings, RA patients should be evaluated early for the presence of IR to reduce the risk of metabolic diseases.

Association between type 1 diabetes mellitus and ankylosing spondylitis: a two-sample Mendelian randomization study

“…Recently, researchers have investigated the relationship between insulin deficiency and rheumatic diseases. A single-center cross-sectional study showed that insulin resistance was evident during early arthritis development, whereas disease activity and age were independent predictors of insulin resistance ( 27 ). Case reports have also confirmed increased levels of anti-insulin antibodies in patients with SLE ( 16 ).…”

Changes of peripheral blood α-L-fucosidase activity in patients with rheumatoid arthritis: a cross-sectional study

“…The development of RA requires the involvement of glucose and lipid metabolism. For example, Arias-de la Rosa et al proved that metabolic disturbances associated with RA, and it is depended on the degree of inflammation and identify inflammation of adipose tissue ( 16 ); moreover, Ye et al proved that RA patients should be evaluated early for the presence of IR to reduce the risk of metabolic diseases ( 17 ). Accordingly, the primary purpose of this study was to investigate the role of the changes of peripheral blood AFU activity in glucose and lipid metabolism in RA patients.…”