Mechanistic and therapeutic links between rheumatoid arthritis and diabetes mellitus

Li, Jing; Chen, Yazhuo; Liu, Qingyun; Tian, Zhufang; Zhang, Yan

doi:10.1007/s10238-022-00816-1

Cited by 15 publications

(21 citation statements)

References 131 publications

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“…46 Another limitation is that only age, sex, and baseline comorbidity were adjusted without considering other confounding factors, such as lifestyle factors (smoking and drinking status, dietary habits), which have been shown to be associated with the risk of RA. 5,47 Nevertheless, a Mendelian randomization study provided genetic evidence supporting TZD as a potential agent to reduce RA risk, 48 which is consistent with our analyses. Additionally, patients with heart failure, active liver disease, or liver enzymes elevated more than 2.5 times the upper limit of normal, as well as patients with severe osteoporosis and a history of fractures, are contraindicated to use TZD.…”

Section: Discussionsupporting

confidence: 85%

“…2,4 There is a close bidirectional relationship between the development of RA and type 2 diabetes mellitus (T2DM) with a growing body of evidence indicating that inflammation is a key factor between insulin resistance, T2DM, and RA. [5][6][7] This relationship further motivates studies to investigate the potential association between antidiabetic drugs and RA. 8 Thiazolidinediones (TZDs) are a class of important second-line glucose-lowering agents and the only antidiabetic medications that primarily decrease insulin resistance by improving insulin sensitivity.…”

Section: Introductionmentioning

confidence: 96%

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Associations Between Thiazolidinediones Use and Incidence of Rheumatoid Arthritis: A Retrospective Population‐Based Cohort Study

Zhao,

Chen,

Sun

et al. 2024

Arthritis Care & Research

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ObjectivePreclinical studies suggest that thiazolidinediones (TZDs) may have a protective effect on rheumatoid arthritis (RA), but evidence from population‐based studies is scarce. This study aimed to assess the association between use of thiazolidinediones and incidence of RA in a retrospective cohort of patients with type 2 diabetes mellitus (T2DM).MethodsA retrospective cohort of T2DM patients who were new users of TZDs or alpha glucosidase inhibitors (AGIs) was assembled. We applied the inverse probability of treatment weighted (IPTW) Cox model to estimate the hazard ratio (HR) of RA incidence associated with the use of TZDs compared with AGIs.ResultsThe final analysis included 56796 new users of AGIs and 14892 new users of TZDs. The incidence of RA was 187.4 and 135.2 per 100,000 person‐years in AGI users and TZD users. Compared with use of AGIs, TZD use was associated with a reduction in RA incidence, with an HR of 0.72 (95% CI, 0.59–0.89). HRs for cumulative use of TZDs for 0.51–4.0 years and > 4 years with incidence of RA, were 0.55 (95% CI, 0.35–0.88) and 0.74 (95% CI,0.57–0.98), respectively. Various subgroup analyses and sensitivity analyses were consistent with the primary analysis.ConclusionUse of TZDs is associated with a decreased risk of incident RA in T2DM patients.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 96%

Associations Between Thiazolidinediones Use and Incidence of Rheumatoid Arthritis: A Retrospective Population‐Based Cohort Study

Zhao,

Chen,

Sun

et al. 2024

Arthritis Care & Research

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“…The causative relationship between diabetes mellitus, both the type 1 (T1DM) and type 2 (T2DM), and RA has been widely documented [ 29 , 30 , 31 ]. Especially, the metabolic relationship between T2DM and RA is under active investigation since insulin resistance has been thought to bridge the two conditions [ 32 , 33 ].…”

Section: Diabetes and Autoimmunity: Is There A Link Through Dpp-4?mentioning

confidence: 99%

Glucose as a Potential Key to Fuel Inflammation in Rheumatoid Arthritis

Masuko

2022

Nutrients

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Glucose is the most important source of energy and homeostasis. Recent investigations are clarifying that glucose metabolism might be altered in rheumatoid arthritis (RA), which would play a role in the inflammatory phenotype of rheumatoid synovial fibroblasts. It may also play a role in a variety of autoimmune diseases’ pathophysiology by modulating immune responses and modifying autoantigen expressions. The research into glucose and its metabolism could lead to a better understanding of how carbohydrates contribute to the occurrence and duration of RA and other autoimmune diseases.

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“…Diabetes patients frequently have obesity, insulin resistance, and uncontrolled hyperglycemia, all of which increase the risk of CV disease. Both type 1 and type 2 DM have inflammation-related pathogenesis, and some of the mediators of inflammation are also present in RA, suggesting a potential connection between these two diseases [ 13 ]. About 20% of RA patients have DM as a comorbidity, and RA is linked to a higher risk of DM development [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Clinical Features of Diabetes Mellitus on Rheumatoid Arthritis: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group

Cacciapaglia

Bartoloni

Bugatti

et al. 2023

JCM

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Rheumatoid arthritis (RA) and diabetes mellitus (DM) are linked by underlying inflammation influencing their development and progression. Nevertheless, the profile of diabetic RA patients and the impact of DM on RA need to be elucidated. This cross-sectional study includes 1523 patients with RA and no episodes of cardiovascular events, followed up in 10 Italian University Rheumatologic Centers between 1 January and 31 December 2019 belonging to the “Cardiovascular Obesity and Rheumatic DISease (CORDIS)” Study Group of the Italian Society of Rheumatology. The demographic and clinical features of DM RA patients were compared to non-diabetic ones evaluating factors associated with increased risk of DM. Overall, 9.3% of the RA patients had DM, and DM type 2 was more common (90.2%). DM patients were significantly older (p < 0.001), more frequently male (p = 0.017), with a significantly higher BMI and mean weight (p < 0.001) compared to non-diabetic patients. DM patients were less likely to be on glucocorticoids (p < 0.001), with a trend towards a more frequent use of b/ts DMARDs (p = 0.08), and demonstrated higher HAQ (p = 0.001). In around 42% of patients (n = 114), DM diagnosis preceded that of RA. Treatment lines were identical in diabetic and non-diabetic RA patients. DM is a comorbidity that may influence RA management and outcome. The association between DM and RA supports the theory of systemic inflammation as a condition underlying the development of both diseases. DM may not have a substantial impact on bDMARDs resistance, although further investigation is required to clarify the implications of biological therapy resistance in RA patients.

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Mechanistic and therapeutic links between rheumatoid arthritis and diabetes mellitus

Cited by 15 publications

References 131 publications

Associations Between Thiazolidinediones Use and Incidence of Rheumatoid Arthritis: A Retrospective Population‐Based Cohort Study

Associations Between Thiazolidinediones Use and Incidence of Rheumatoid Arthritis: A Retrospective Population‐Based Cohort Study

Glucose as a Potential Key to Fuel Inflammation in Rheumatoid Arthritis

Clinical Features of Diabetes Mellitus on Rheumatoid Arthritis: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group

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