RT Journal Article
T1 Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: cross-sectional study.
A1 Manrique-Arija, Sara
A1 Mena-Vazquez, Natalia
A1 Ureña, Inmaculada
A1 Rioja, Jose
A1 Valdivielso, Pedro
A1 Ginel-Mendoza, Leovigildo
A1 Abad-Sanchez, Salome
A1 Jimenez-Nuñez, Francisco G
A1 Oliver-Martos, Begoña
A1 Fernandez-Nebro, Antonio
K1 Diabetes 
K1 Rheumatology
K1 Endocrinology
AB To describe the prevalence of insulin resistance (IR) in patients with established rheumatoid arthritis (RA) and to analyse the contribution of cumulative inflammatory burden and other factors to its development. Observational cross-sectional study. Patients with RA and controls matched for age, sex and Body Mass Index. We excluded patients with diabetes. Patients from an RA inception cohort at Hospital Regional Universitario de Málaga, Spain, were recruited between September 2016 and May 2018. IR was evaluated using the homeostasis model assessment for IR and beta-cell function and the quantitative insulin sensitivity check index. Other variables included the cumulative 28-Joint Disease Activity Score (DAS28) with C reactive protein (CRP) body composition and cytokines. Two logistic regression models were constructed to identify factors associated with IR in patients with RA. Eighty-nine patients with RA and 80 controls were included. The prevalence of IR was similar in both cases and controls. Inflammatory activity was controlled appropriately in patients during follow-up (mean DAS28 3.1 (0.8)). The presence of IR in patients with RA was associated with obesity (OR 6.01, 95% CI 1.9 to 8.7), higher cumulative DAS28-CRP values during follow-up (OR 2.8, 95% CI 1.3 to 6.0), and higher interleukin-1β levels (OR 1.6, 95% CI 1.1 to 2.4). The second model showed that the risk of IR increased by 10% for each kilogram of excess body fat. In patients with well-controlled, established RA, IR is associated mainly with poorer control of inflammation from diagnosis and with obesity, specifically total fat mass.
PB BMJ Group
YR 2021
FD 2021-01-13
LK http://hdl.handle.net/10668/17136
UL http://hdl.handle.net/10668/17136
LA en
NO Manrique-Arija S, Mena-Vazquez N, Ureña I, Rioja J, Valdivielso P, Ginel-Mendoza L, et al. Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: cross-sectional study. BMJ Open. 2021 Feb 9;11(2):e044749
DS RISalud
RD Apr 5, 2025