Increased insulin resistance in rheumatoid arthritis

Increased insulin resistance in rheumatoid arthritis

(HealthDay)—Patients with rheumatoid arthritis (RA) have elevated insulin resistance (IR), but this is not associated with increased atherosclerosis risk, according to a study published online Dec. 10 in Arthritis & Rheumatology.

Jon T. Giles, M.D., M.P.H., from Columbia University in New York City, and colleagues compared IR (estimated using the homeostatic model [HOMA-IR]) between 95 RA patients and 98 demographically-matched non-RA controls.

The researchers found that the average HOMA-IR levels were 31 percent higher in the RA group, regardless of strata of demographic or cardiometabolic risk factors. In the control group, HOMA-IR was strongly and significantly associated with C-reactive protein and interleukin-6, but this association was weaker in the RA group. Higher HOMA-IR correlated with rheumatoid factor positivity in men and women, and with prednisone use in women, among those with RA. Higher HOMA-IR correlated with all assessed subclinical atherosclerosis measures in the control group before adjustment; after adjustment for cardiovascular risk factors, the correlations were attenuated and were no longer statistically significant. Over an average of 3.2 years of follow-up, neither baseline nor average HOMA-IR correlated with change in any measures of atherosclerosis among the RA patients.

"Although IR was higher in RA than in non-RA controls, higher levels may not independently impart additional risk," the authors write.

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