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Insulin resistance and levels of adipokines in patients with untreated early rheumatoid arthritis.
Clin Rheumatol. 2016 Jan; 35(1):43-53.CR

Abstract

The aim of this study is to investigate the presence of insulin resistance (IR) in patients with untreated early rheumatoid arthritis (ERA) and its relationship with adipokines, inflammatory cytokines, and treatment. In this prospective study, we enrolled 46 ERA patients with a disease duration of <1 year, and 45 sex-, age-, race-, and body mass index (BMI)-matched controls. Patients and controls with diabetes or a history of glucocorticoid (GC) or disease-modifying antirheumatic drugs (DMARDs) use were excluded. Patients were assessed at the time of diagnosis (visit 1) and after 6 months of treatment (visit 2). The main outcomes were homeostatic model assessment of IR (HOMA-IR) and β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). A multivariate regression analysis was performed to analyze IR adjusting according to lipids, body composition, physical activity, nutrition, and inflammatory cytokine and adipokine levels. The baseline HOMA-IR, HOMA-β, and QUICKI values were similar in both groups. However, patients showed lower levels of physical activity, total cholesterol, and high-density lipoprotein. Moreover, the inflammatory cytokines and resistin concentrations were higher in patients than controls. Multivariate analysis indicated that BMI and baseline rheumatoid factor levels were positively associated with HOMA-IR and HOMA-β, and negatively with QUICKI. After DMARD treatment, patients showed improvements in inflammatory parameters and lipids whereas IR remained stable. Furthermore, adiponectin and resistin concentrations decreased slightly. Our data suggest that IR is not present in ERA patients either at diagnosis or at 6 months after treatment. However, symptom duration and fat mass appear to be related.

Authors+Show Affiliations

UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.UGC de Medicina Interna, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain.Departamento de Medicina y Dermatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain. afernandezn@uma.es.

Pub Type(s)

Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26526677

Citation

Manrique-Arija, Sara, et al. "Insulin Resistance and Levels of Adipokines in Patients With Untreated Early Rheumatoid Arthritis." Clinical Rheumatology, vol. 35, no. 1, 2016, pp. 43-53.
Manrique-Arija S, Ureña I, Valdivielso P, et al. Insulin resistance and levels of adipokines in patients with untreated early rheumatoid arthritis. Clin Rheumatol. 2016;35(1):43-53.
Manrique-Arija, S., Ureña, I., Valdivielso, P., Rioja, J., Jiménez-Núñez, F. G., Irigoyen, M. V., & Fernández-Nebro, A. (2016). Insulin resistance and levels of adipokines in patients with untreated early rheumatoid arthritis. Clinical Rheumatology, 35(1), 43-53. https://doi.org/10.1007/s10067-015-3106-8
Manrique-Arija S, et al. Insulin Resistance and Levels of Adipokines in Patients With Untreated Early Rheumatoid Arthritis. Clin Rheumatol. 2016;35(1):43-53. PubMed PMID: 26526677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Insulin resistance and levels of adipokines in patients with untreated early rheumatoid arthritis. AU - Manrique-Arija,Sara, AU - Ureña,Inmaculada, AU - Valdivielso,Pedro, AU - Rioja,José, AU - Jiménez-Núñez,Francisco G, AU - Irigoyen,María V, AU - Fernández-Nebro,Antonio, Y1 - 2015/11/03/ PY - 2015/05/09/received PY - 2015/10/21/accepted PY - 2015/10/03/revised PY - 2015/11/4/entrez PY - 2015/11/4/pubmed PY - 2016/10/8/medline KW - Adipokines KW - DMARDs KW - Early rheumatoid arthritis KW - Insulin resistance SP - 43 EP - 53 JF - Clinical rheumatology JO - Clin. Rheumatol. VL - 35 IS - 1 N2 - The aim of this study is to investigate the presence of insulin resistance (IR) in patients with untreated early rheumatoid arthritis (ERA) and its relationship with adipokines, inflammatory cytokines, and treatment. In this prospective study, we enrolled 46 ERA patients with a disease duration of <1 year, and 45 sex-, age-, race-, and body mass index (BMI)-matched controls. Patients and controls with diabetes or a history of glucocorticoid (GC) or disease-modifying antirheumatic drugs (DMARDs) use were excluded. Patients were assessed at the time of diagnosis (visit 1) and after 6 months of treatment (visit 2). The main outcomes were homeostatic model assessment of IR (HOMA-IR) and β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). A multivariate regression analysis was performed to analyze IR adjusting according to lipids, body composition, physical activity, nutrition, and inflammatory cytokine and adipokine levels. The baseline HOMA-IR, HOMA-β, and QUICKI values were similar in both groups. However, patients showed lower levels of physical activity, total cholesterol, and high-density lipoprotein. Moreover, the inflammatory cytokines and resistin concentrations were higher in patients than controls. Multivariate analysis indicated that BMI and baseline rheumatoid factor levels were positively associated with HOMA-IR and HOMA-β, and negatively with QUICKI. After DMARD treatment, patients showed improvements in inflammatory parameters and lipids whereas IR remained stable. Furthermore, adiponectin and resistin concentrations decreased slightly. Our data suggest that IR is not present in ERA patients either at diagnosis or at 6 months after treatment. However, symptom duration and fat mass appear to be related. SN - 1434-9949 UR - https://www.unboundmedicine.com/medline/citation/26526677/Insulin_resistance_and_levels_of_adipokines_in_patients_with_untreated_early_rheumatoid_arthritis_ L2 - https://dx.doi.org/10.1007/s10067-015-3106-8 DB - PRIME DP - Unbound Medicine ER -