medwireNews: Disease activity has been identified as a significant risk factor for impaired glucose metabolism among patients with rheumatoid arthritis (RA).
The study included 90 RA patients and 37 healthy controls matched on traditional risk factors for insulin resistance such as age, BMI, waist circumference, and metabolic syndrome. None of the participants had diabetes.
As reported in Arthritis Research & Therapy, people with RA had a significantly higher degree of insulin resistance as measured by the HOMA2-IR index than controls, with average scores of 1.4 versus 1.2. Multivariate analysis demonstrated that “almost all disease activity parameters,” including DAS28-ESR, DAS28-CRP, VAS, and tender joint count (TJC) scores, were independent predictors of insulin resistance in RA patients, as was matrix metalloproteinase (MMP)3 concentration.
“As MMP3 is a more reliable serological marker for RA activity than acute-phase reactants or inflammatory cytokines, this finding amplifies the importance of the disease itself,” write Gorica Ristić (University of Defense in Belgrade, Serbia) and team.
They also found that having a DAS28-ESR score of 5.1 points or more was “the main contributor” to the increased risk for insulin resistance, followed by TJC and VAS scores, independently of the traditional risk factors, which they say “reinforce[s] the importance of RA activity.”
Ristić and team note that a “complex interplay of inflammation, physical inactivity, changes in lipid profiles, different therapies, and the degree of disease activity” could influence the degree of insulin resistance in RA patients, and recommend further research to reveal the underlying mechanisms.
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