Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: Risk reduction in a chronic inflammatory disease

2011 ◽  
Vol 63 (4) ◽  
pp. 512-521 ◽  
Author(s):  
Mary Chester Wasko ◽  
Jonathan Kay ◽  
Elizabeth C. Hsia ◽  
Mahboob U. Rahman
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Risk Reduction ◽  
Inflammatory Disease ◽  
Chronic Inflammatory Disease ◽  
Rheumatoid Arthritis Risk

scholarly journals POS0561 OBESITY PHENOTYPES IN EARLY RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 515.1-515
Author(s):  
Y. Gorbunova ◽  
T. Popkova ◽  
L. Kondrateva ◽  
M. Cherkasova ◽  
E. Nasonov ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Waist Circumference ◽  
Metabolic Disorders ◽  
Normal Weight ◽  
Atherogenic Index ◽  
World Health ◽  
Early Ra ◽  
Metabolically Healthy

Background:Patients with rheumatoid arthritis (RA) and obesity have a lower risk of early death than patients with normal weight due to the so-called “obesity paradox”. Available publications discuss three phenotypes of obesity: classical obesity, metabolically healthy overweight/obesity, and latent obesity (normal weight associated with metabolic disorders, most importantly - with insulin resistance and adipocytokines imbalance).Objectives:To clarify the prevalence of obesity phenotypes and to identify factors predisposing to «latent obesity» in early RA without diabetes mellitus or hyperglycemia.Methods:The study included 35 pts (23 women, 12 men) with early RA (criteria ACR / EULAR, 2010), 56 [43,0; 60,0] years old, naïve to treatment with glucocorticoids and disease-modifying anti-rheumatics, without established diabetes mellitus. Pts were seropositive for IgM RF and anti-CCP, with highly active RA (DAS28 5,9 [5,2; 6,4]; SDAI 35,4 [27,0; 45,8], and CDAI 31,0 [26,0; 44,0]) scores, and median disease duration of 8.0 [6,0;15.0] months. Electrochemiluminescence assay Elecsys (Roche Diagnostics) was used to measure patients’ insulin levels, and ELISA (DBS – Diagnostics Biochem Canada Inc.) - for evaluation of serum leptin concentrations. Insulin resistance (IR) was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. Leptin levels were considered elevated at values ≥11,1 ng/ml for women, ≥5,6 ng/ml for men. The overweight/obesity status was determined by World Health Organization criteria in pts with body mass index (BMI) ≥25kg/m2.Results:Overweight/obesity were documented in 19 (54, 3%) pts with early RA, 4/19 (21%) had high leptin levels and IR, 11/19 (58%) had isolated hyperleptinemia. Normal BMI was found in 16 (45,7%) pts with early RA, 2/16 (12,5%) had elevated leptin levels and IR, and 6/16 (37,5%) – only hyperleptinemia. Four (21%) out of 19 overweight and 8 (50%) out of 16 pts with normal BMI did not show any metabolic disorders (p=0,02). Сlassical obesity was found in 15 (43%), and latent obesity – in 8 (23%) pts with early RA. Leptin levels correlated with waist circumference (r=0,58, p=0,02), BMI (r=0,71, p=0,0006), ESR (r=0,5, p=0,02) in the overweight/obese pts, and with waist circumference (r=0,59, p=0,03), IgM RF (r=0,58, p=0,03), triglyceride levels (r=0,77, p=0,003), and atherogenic index (r=0,62, p=0,03) in pts with normal weight.Conclusion:The classical obesity phenotype associated with abdominal obesity and inflammation was the most common and prevailing over other phenotypes in early RA. Latent obesity was less common and was associated with an unfavorable lipid profile and accumulation of abdominal fat, therefore increasing the risk of cardiovascular diseases in RA. Metabolically healthy overweight/obesity in early RA was really a rare phenotype.Disclosure of Interests:None declared

scholarly journals Efficacy of Rituximab on Rheumatoid Leptomeningitis as the First Symptom of Rheumatoid Arthritis

2021 ◽  
Author(s):  
Mickaël Chouk ◽  
Alexandre Halb ◽  
Christine Mekhail ◽  
Amélie Godot ◽  
Frank Verhoeven ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cognitive Impairment ◽  
Clinical Examination ◽  
Inflammatory Disease ◽  
Chronic Inflammatory Disease ◽  
One Year

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized mainly by arthritis, with the possible occurrence of extra-articular manifestations. We report the case of a patient who developed leptomeningitis as the first sign of RA, one year before the diagnosis of RA. Methylprednisolone 1000 mg was given intravenously. Because of the onset of seizures and cognitive impairment, rituximab was started. After three cycles of rituximab (1000 mg on day 0 and 1000 mg on day 15, every 6 months), neurological clinical examination, MRI and electroencephalogram findings were significantly improved.

scholarly journals The TNFA -857C/T Polymorphism: Association with Rheumatoid Arthritis and Anti-CCP Levels in a Mexican Population

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Juan Manuel Agraz-Cibrián ◽  
Gabriela Nohemí Espinoza-De León ◽  
Ma. de Jesús Durán-Avelar ◽  
Norberto Vibanco-Pérez ◽  
Liliana Ortiz-Martínez ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factor ◽  
Clinical Features ◽  
Inflammatory Disease ◽  
Chronic Inflammatory Disease ◽  
Clinical Parameters ◽  
Healthy Controls ◽  
Candidate Marker ◽  
Hardy Weinberg Equilibrium ◽  
Different Populations

Rheumatoid arthritis (RA) is a chronic inflammatory disease whose association with SNPs has led to the identification of biomarkers in different populations. To determine the association of the -857C/T SNP of the TNFA gene with RA and clinical parameters, 233 RA patients and 237 healthy controls were included in this study. The -857C/T polymorphism was determined using the TaqMan® system and clinical features were also determined. We found that the -857C/T SNP was in Hardy-Weinberg equilibrium. Our results showed no association of the -857C/T SNP with RA; however, RA patients carrying the TT genotype showed lower anti-CCP levels than other groups. Therefore, the TT genotype could be a risk factor for developing anti-CCP-negative RA. Our results suggest that the T allele of the TNFA -857C/T SNP exerts an influence on anti-CCP levels and could be a candidate marker for anti-CCP-negative RA.

scholarly journals Extra-articular rheumatoid arthritis

Reumatismo ◽  
2018 ◽  
Vol 70 (4) ◽  
pp. 212-224 ◽  
Author(s):  
E. Marcucci ◽  
E. Bartoloni ◽  
A. Alunno ◽  
M.C. Leone ◽  
G. Cafaro ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
General Practitioners ◽  
Inflammatory Disease ◽  
Health Professionals ◽  
Cardiovascular Events ◽  
Chronic Inflammatory Disease ◽  
Rheumatoid Nodules

Rheumatoid arthritis (RA) is a chronic inflammatory disease that mainly affects the joints, though a consistent proportion of patients may also display extra articular manifestations (EAMs). From rheumatoid nodules to interstitial lung disease, from cardiovascular events to vasculitis, the spectrum of EAMs encompasses various conditions with different prognoses. EAMs may also occur as first RA manifestation, therefore the coordination with other health professionals, including general practitioners, is needed. The aim of this article is to provide an overview on EAMs in RA with particular focus on the recognised risk factors and the available recommendations for managing them, as well as comorbidities in RA patients.

scholarly journals Early Prediction of Increased Arterial Stiffness in Patients with Chronic Inflammation: A 15-year Followup Study of 108 Patients with Rheumatoid Arthritis

2011 ◽  
Vol 38 (4) ◽  
pp. 606-612 ◽  
Author(s):  
SELLA A. PROVAN ◽  
KRISTIN ANGEL ◽  
ANNE GRETE SEMB ◽  
PETTER MOWINCKEL ◽  
STEFAN AGEWALL ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Arterial Stiffness ◽  
Disease Activity ◽  
Inflammatory Disease ◽  
Augmentation Index ◽  
Chronic Inflammatory Disease ◽  
Reactive Protein ◽  
Cardiovascular Morbidity And Mortality ◽  
Early Markers ◽  
Radiographic Data

Objective.Patients with rheumatoid arthritis (RA), a chronic inflammatory disease, have increased cardiovascular morbidity and mortality. We investigated whether early markers of RA inflammatory disease activity could predict later increased levels of pulse-wave velocity (PWV) and augmentation index (AIx), 2 measures of arterial stiffness.Methods.In total 238 patients with early RA were followed longitudinally and 108 were available for the 15-year followup examination. Comprehensive baseline clinical and radiographic data were collected in 1992. Arterial stiffness, measured as AIx and PWV (Sphygmocor apparatus), was recorded at the 15-year followup. Adjusted logistic univariate and multivariate analyses were performed with levels of AIx and PWV as the dependent variables, and variables reflecting baseline RA disease activity as possible predictors. The validity of the final models was examined in linear regression analyses.Results.Baseline C-reactive protein (CRP) above the median predicted increased AIx (OR 3.52, 95% CI 1.04–11.90) and PWV (OR 4.84, 95% CI 1.39–16.83) at the 15-year assessment in multivariate models. Patients with elevated baseline CRP had significantly higher AIx (ß = 2.67, 95% CI 0.06–5.31, p = 0.045) and lnPWV (ß = 0.08, 95% CI 0.01–0.14, p = 0.02) after 15 years, after adjustments for age, sex, heart rate (AIx only) and mean arterial pressure.Conclusion.Inflammation early in the RA disease course was associated with increased AIx and PWV after 15 years. These findings support the importance of early control of the inflammatory process in patients with RA.

scholarly journals Risk Factors and Early Detection of Diabetes Mellitus in Early Rheumatoid Arthritis WomenBackground: Patients with rheumatoid arthritis show predominance of metabolic disorder characterized by overweight, central obesity, dyslipidemia and impaired glucose

2018 ◽  
Vol 60 (1) ◽  
pp. 74-76
Author(s):  
Mohammad H. Ali ◽  
Abeer J. Hassan ◽  
Enas J. Hasan
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Early Rheumatoid Arthritis ◽  
Metabolic Disorder ◽  
Central Obesity ◽  
Rheumatoid Arthritis Group ◽  
Control Group ◽  
Fasting Insulin ◽  
Healthy Control

Background: Patients with rheumatoid arthritis show predominance of metabolic disorder characterized by overweight, central obesity, dyslipidemia, and impaired glucose tolerance, specifically, few studies have explained insulin resistance in this disease.Objective: The aim of the present study is to examine insulin resistance and the risk of developing diabetes mellitus in middle age Iraqi women with early rheumatoid arthritis.Patients and methods: This work involved seventy female with early rheumatoid arthritis. Who was attending to the National Diabetic Center (NDC) of Al-Mustansiriya University and 35 healthy subjects as a control group. From all subjects blood sample was drawn in fasting state to measure the biochemical parameters which including plasma glucose level and fasting insulin concentrations. Other measurements (RF and anti-CCP) were made by routine methods. Homeostasis model of assessment insulin resistance (HOMA-IR) by using the formula HOMA model Insulin sensitivity was calculated in RA patients and healthy control.Results: Results revealed a highly significant in the level of the rheumatoid factor (RF), anti-CCP and fasting insulin, and HOMA-IR when compared the patient group with the control group. While a significant increase in the level of FBG in the RA group than the control group. Also, there was a positive correlation with high significance among, Anti-CCP, and RF with HOMA-IR in the rheumatoid arthritis group. Conclusions: This study shows that patient with rheumatoid arthritis have abnormal insulin secretion with a high value of IR than a group of healthy control and these patients may be at risk of diabetic mellitus.  عوامل الخطر والتشخيص المبكر لداء السكري للنساء حديثات الاصابة بألتهاب المفاصل الروماتويدي محمد حسن علي  د.عـبير جبـار حسن أيناس جبار حسن  الخلاصة: خلفية البحث:يكون المرضى الذين يعانون من التهاب المفاصل الروماتويدي عرضة للاصابة بمتلازمة التمثيل بالغذائي والعوامل المرتبطة بها مثل زيادة الوزن، وقلة دهون الدم أو ضعف تحمل الجلوكوز، وهناك بعض الدراسات بينت ان هولاء المرضى يكونون معرضون لمقاومة الانسولين . الهدف: صممت هذه الدراسة لفحص مقاومة الانسولين وخطر الإصابة بداء السكري عند النساء العراقيات المصابات حديثا بالتهاب المفاصل الروماتويدي. طرق العمل: شملت الدراسة سبعين أنثى مصابات حديثا بالتهاب المفاصل الروماتويدي و 35 من النساء المتطوعات كمجموعة ضابطة. تم سحب عينة الدم من الجميع في حالة الصيام لقياس المعلمات البيوكيميائية بما في ذلك مستوى الجلوكوز ، تركيزالأنسولين وقياسات أخرى مثل (RF and anti-CCP). وايضا تم حساب المقاومة للانسولين (HOMA-IR). النتائج أظهرت النتائج وجود زيادة معنوية في مستوى العامل الروماتويدي (RF) وتركيز الانسولين مقاومة الانسولين (HOMA-IR) عند مقارنة مجموعة المرضى مع مجموعة السيطرة. في حين أن زيادة كبيرة في مستوى السكر الصائم  في مجموعة المرضى مقارنة بالمجموعة الضابطة. أيضا كان هناك علاقة إيجابية  مؤثرة بين، Anti-CCP, and RF  و HOMA-IR في مجموعة مرضى التهاب المفاصل الروماتويدي. الاستنتاجات: اظهرت نتائج هذه الدراسة أن المرضى بالتهاب المفاصل الروماتويدي يكون لديهم إفراز الأنسولين غير طبيعي وبالتالي تظهر لديهم مقاومة للانسولين ويكونون عرضة لخطر الاصابة بمرض السكري. الكلمات المفتاحية: مقاومة الانسولين,  داء السكري, التهاب المفاصل الروماتويدي.

scholarly journals INSULIN RESISTANCE AND ENDOTHELIAL DYSFUNCTION IN RHEUMATOID ARTHRITIS

2016 ◽  
Vol 25 (3) ◽  
pp. 117-121
Author(s):  
Alexandru Caraba ◽  
◽  
Viorica Crisan ◽  
Ioan Romosan ◽  
Marius Murariu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Insulin Resistance ◽  
Endothelial Dysfunction ◽  
Disease Activity ◽  
Direct Action ◽  
Cardiovascular Complications ◽  
Chronic Inflammatory Disease ◽  
Atherosclerotic Cardiovascular Disease ◽  
Newly Diagnosed ◽  
High Insulin

Rheumatoid arthritis is a chronic inflammatory disease, in which, besides articular involvement, cardiovascular complications due to premature and accelerated atherosclerosis represent a serious problem. Endothelial dysfunction is the first step in the atherosclerosis development. Rheumatoid arthritis associated inflammation contributes to endothelial dysfunction through direct action of cytokines on endothelium, or via increased insulin resistance. The aim of this study was represented by the assessment of endothelial dysfunction in rheumatoid arthritis patients, and correlation of this with impaired insulin sensitivity. Material and methods. The study was performed on a group of 35 patients with newly diagnosed rheumatoid arthritis. In all patients were assessed: rheumatoid arthritis activity (DAS28), insulin resistance (HOMA-IR) and endothelial dysfunction by means of flow-mediated dilation (FMD). Results. Inflammation was present in all patients, and the disease activity was high (DAS28: 6.41 ± 0.94). The studied patients showed high insulin resistance (HOMA-IR 5.97 ± 1.89) and endothelial dysfunction (FMD 7.94 ± 0.91%). There were significant correlations between endothelial dysfunction and insulin resistance (p = 0.0174), respective disease activity (p = 0.0201). On the other hand, it was shown a correlation between insulin resistance and the disease activity (p = 0.0290). Conclusion. Endothelial dysfunction was present even in newly diagnosed rheumatoid arthritis patients, contributing to the development of later atherosclerotic cardiovascular disease. Insulin resistance represented an important factor involved in endothelial dysfunction appearance.

Sign in / Sign up

Export Citation Format

Share Document