Incidence and effect of insulin resistance on progression of atherosclerosis in rheumatoid arthritis patients of long disease duration
Copyright © 2019 Chang Gung University. Published by Elsevier B.V. All rights reserved..
BACKGROUND: The continued atherosclerotic risk in rheumatoid arthritis (RA) has been inadequately explained by conventional factors. Chronic inflammation and endothelial activation seems responsible for developing insulin resistance (IR). The study was aimed to assess the role of inflammation and endothelial activation causing IR in long term RA patients leading to increased atherosclerotic risk.
METHODS: Fifty (25 long-duration and 25 short-duration) RA patients and twenty-three healthy controls were recruited excluding potential confounding co-morbidities. Fasting insulin, proinflammatory cytokines, endothelial stress markers and adipokines were quantified by ELISA. Homeostasis Model Assessment (HOMA)-IR calculated using glucose and insulin values. Atherosclerotic indices were measured using ultrasound.
RESULTS: Lipid profile was comparable among groups. Mean carotid intima media thickness (cIMT) was significantly higher in both RA groups (p = 0.0062) compared to controls. HOMA-IR was significantly higher in long-duration RA (p = 0.005); it showed significant associations with DAS 28 (p = 0.01) and hsCRP (p = 0.03) in this subset. Mean cIMT for short-duration RA (p = 0.02) and long-duration RA (p = 0.0006) respectively was also significantly associated with HOMA-IR. Pro-inflammatory markers like TNF-α, resistin and leptin were highest in long-duration RA, higher in short-duration RA when compared to control group respectively. HOMA-IR was significantly dependent on TNF-α (p = 0.008), resistin (p = 0.031), leptin (p = 0.0054). Mean cIMT showed association with all parameters mainly with TNF-α (p = 0.001), iNOS (p = 0.001), resistin (p = 0.008) and leptin (p = 0.04).
CONCLUSIONS: Persistent inflammation leads to altered adipokine secretion promoting IR in RA patients with long disease duration. Treatment with conventional disease modifying anti-rheumatic drugs (DMARDs) is incomplete to control chronic inflammation and limit progression of atherosclerosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:42 |
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| Enthalten in: |
Biomedical journal - 42(2019), 6 vom: 15. Dez., Seite 394-402 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Guin, Aharna [VerfasserIn] |
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| Links: |
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| Themen: |
Atherosclerosis |
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| Anmerkungen: |
Date Completed 03.08.2020 Date Revised 03.08.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.bj.2019.01.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM305469010 |
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| 245 | 1 | 0 | |a Incidence and effect of insulin resistance on progression of atherosclerosis in rheumatoid arthritis patients of long disease duration |
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| 500 | |a Date Revised 03.08.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Chang Gung University. Published by Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: The continued atherosclerotic risk in rheumatoid arthritis (RA) has been inadequately explained by conventional factors. Chronic inflammation and endothelial activation seems responsible for developing insulin resistance (IR). The study was aimed to assess the role of inflammation and endothelial activation causing IR in long term RA patients leading to increased atherosclerotic risk | ||
| 520 | |a METHODS: Fifty (25 long-duration and 25 short-duration) RA patients and twenty-three healthy controls were recruited excluding potential confounding co-morbidities. Fasting insulin, proinflammatory cytokines, endothelial stress markers and adipokines were quantified by ELISA. Homeostasis Model Assessment (HOMA)-IR calculated using glucose and insulin values. Atherosclerotic indices were measured using ultrasound | ||
| 520 | |a RESULTS: Lipid profile was comparable among groups. Mean carotid intima media thickness (cIMT) was significantly higher in both RA groups (p = 0.0062) compared to controls. HOMA-IR was significantly higher in long-duration RA (p = 0.005); it showed significant associations with DAS 28 (p = 0.01) and hsCRP (p = 0.03) in this subset. Mean cIMT for short-duration RA (p = 0.02) and long-duration RA (p = 0.0006) respectively was also significantly associated with HOMA-IR. Pro-inflammatory markers like TNF-α, resistin and leptin were highest in long-duration RA, higher in short-duration RA when compared to control group respectively. HOMA-IR was significantly dependent on TNF-α (p = 0.008), resistin (p = 0.031), leptin (p = 0.0054). Mean cIMT showed association with all parameters mainly with TNF-α (p = 0.001), iNOS (p = 0.001), resistin (p = 0.008) and leptin (p = 0.04) | ||
| 520 | |a CONCLUSIONS: Persistent inflammation leads to altered adipokine secretion promoting IR in RA patients with long disease duration. Treatment with conventional disease modifying anti-rheumatic drugs (DMARDs) is incomplete to control chronic inflammation and limit progression of atherosclerosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Atherosclerosis | |
| 650 | 4 | |a Endothelial stress | |
| 650 | 4 | |a Inflammation | |
| 650 | 4 | |a Insulin resistance | |
| 650 | 4 | |a Rheumatoid arthritis | |
| 650 | 7 | |a Cytokines |2 NLM | |
| 650 | 7 | |a Insulin |2 NLM | |
| 700 | 1 | |a Sinhamahapatra, Pradyot |e verfasserin |4 aut | |
| 700 | 1 | |a Misra, Sanchaita |e verfasserin |4 aut | |
| 700 | 1 | |a Choudhury Mazumder, Sampurna Roy |e verfasserin |4 aut | |
| 700 | 1 | |a Chatterjee, Sudipta |e verfasserin |4 aut | |
| 700 | 1 | |a Ghosh, Alakendu |e verfasserin |4 aut | |
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