Juan C Quevedo-Abeledo1, Hiurma Sánchez-Pérez2, Beatriz Tejera-Segura3, Laura de Armas-Rillo4, Soledad Ojeda1, Celia Erausquin1, Miguel Á González-Gay5, Iván Ferraz-Amaro6. 1. J.C. Quevedo-Abeledo, MD, S. Ojeda, PhD, MD, C. Erausquin, PhD, MD, Division of Rheumatology, Hospital Doctor Negrín, Gran Canaria, Spain. 2. H. Sánchez-Pérez, MD, I. Ferraz-Amaro, PhD, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain. 3. B. Tejera-Segura, PhD, MD, Division of Rheumatology, Hospital Insular de Gran Canaria, Gran Canaria, Spain. 4. L. de Armas-Rillo, PhD, Division of Health Sciences, Universidad Europea de Canarias, Tenerife, Spain. 5. M.Á. González-Gay, PhD, MD, School of Medicine, University of Cantabria, and Division of Rheumatology, Hospital Marqués de Valdecilla, Santander, Spain, and Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. miguelaggay@hotmail.com iferrazamaro@hotmail.com. 6. H. Sánchez-Pérez, MD, I. Ferraz-Amaro, PhD, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; miguelaggay@hotmail.com iferrazamaro@hotmail.com.
Abstract
OBJECTIVE: Since insulin resistance (IR) is highly prevalent in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), we aimed to determine whether differences in IR exist between the two conditions. METHODS: We conducted a cross-sectional study comprising 413 subjects without diabetes (186 with SLE and 227 with RA). Glucose, insulin, and C-peptide serum levels, as well as IR by the homeostatic model assessment (HOMA2) were studied. A multivariable regression analysis was performed to evaluate the differences in IR indexes between patients with SLE and RA, as well as to determine if IR risk factors or disease-related characteristics are differentially associated with IR in both populations. RESULTS: The insulin:C-peptide molar ratio was upregulated in patients with RA compared to patients with SLE (β 0.009, 95% CI 0.005-0.014, P < 0.001) after multivariable analysis. HOMA2 indexes related to insulin sensitivity (HOMA2-%S) were found to be lower (β -27, 95% CI -46 to -9, P = 0.004) and β cell function (HOMA2-%B) showed higher IR indexes (β 38, 95% CI 23-52, P < 0.001) in RA than in SLE patients after multivariable analysis. Patients with RA more often fulfilled the definition of IR than those with SLE (OR 2.15, 95% CI 1.25-3.69, P = 0.005). The size effect of IR factors on IR indexes was found to be equal in both diseases. CONCLUSION: IR sensitivity is lower and β cell function is higher in RA than in SLE patients. The fact that traditional IR factors have an equal effect on IR in both SLE and RA supports the contention that these differences are related to the diseases themselves.
OBJECTIVE: Since insulin resistance (IR) is highly prevalent in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), we aimed to determine whether differences in IR exist between the two conditions. METHODS: We conducted a cross-sectional study comprising 413 subjects without diabetes (186 with SLE and 227 with RA). Glucose, insulin, and C-peptide serum levels, as well as IR by the homeostatic model assessment (HOMA2) were studied. A multivariable regression analysis was performed to evaluate the differences in IR indexes between patients with SLE and RA, as well as to determine if IR risk factors or disease-related characteristics are differentially associated with IR in both populations. RESULTS: The insulin:C-peptide molar ratio was upregulated in patients with RA compared to patients with SLE (β 0.009, 95% CI 0.005-0.014, P < 0.001) after multivariable analysis. HOMA2 indexes related to insulin sensitivity (HOMA2-%S) were found to be lower (β -27, 95% CI -46 to -9, P = 0.004) and β cell function (HOMA2-%B) showed higher IR indexes (β 38, 95% CI 23-52, P < 0.001) in RA than in SLEpatients after multivariable analysis. Patients with RA more often fulfilled the definition of IR than those with SLE (OR 2.15, 95% CI 1.25-3.69, P = 0.005). The size effect of IR factors on IR indexes was found to be equal in both diseases. CONCLUSION: IR sensitivity is lower and β cell function is higher in RA than in SLEpatients. The fact that traditional IR factors have an equal effect on IR in both SLE and RA supports the contention that these differences are related to the diseases themselves.
Authors: Candelaria Martín-González; Tomás Martín-Folgueras; Miguel Á González-Gay; Iván Ferraz-Amaro; Juan Carlos Quevedo-Abeledo; Antonia de Vera-González; Alejandra González-Delgado; Laura de Armas-Rillo Journal: Arthritis Res Ther Date: 2022-05-30 Impact factor: 5.606