Institute of Clinical Medicine, University of Tartu, L. Puusepa 8, 51014 Tartu, Estonia.
Internal Medicine Clinic, Tartu University Hospital, L. Puusepa 8, 51014 Tartu, Estonia.
Biomed Res Int. 2017;2017:9584720. doi: 10.1155/2017/9584720. Epub 2017 Aug 28.
In established rheumatoid arthritis (RA), the presence of insulin resistance (IR) is well proven but, in the early stage of the disease, data are inconclusive. We evaluated the presence of IR and associations with body composition (BC) parameters among early RA (ERA) and control subjects. The study group consisted of 92 ERA and 321 control subjects. Using homeostatic model assessment of IR (HOMA-IR), the cut-off value for IR was 2.15. 56% of the ERA patients and 25% of the controls had IR. Of the BC parameters, patients with early RA had less fat-free mass and appendicular lean mass (ALM). In multivariable model, ERA group (-Coefficient) (4.8, CI: 2.6-8.8), male gender (7.7, CI: 2.7-22.1), and fat mass index (1.2, CI: 1.1-1.4) were associated with IR. Insulin-resistant ERA patients had higher inflammatory markers and higher disease activity. In the multivariable model in the ERA group, IR was associated with male gender (-Coefficient) (7.4, CI: 153-34.9), high disease activity (6.2, CI: 1.7-22.2), and lower ALM (0.03, CI: 0.001-0.97). IR develops in the early stage of RA in the majority of patients. IR is more common among males and is associated with RA disease activity and lower ALM.
在已确诊的类风湿关节炎（RA）中，胰岛素抵抗（IR）的存在已得到充分证实，但在疾病早期，数据尚无定论。我们评估了早期 RA（ERA）患者和对照组中 IR 的存在及其与身体成分（BC）参数的相关性。研究组包括 92 名 ERA 患者和 321 名对照组。使用稳态模型评估胰岛素抵抗（HOMA-IR），IR 的截断值为 2.15。56%的 ERA 患者和 25%的对照组存在 IR。在 BC 参数方面，早期 RA 患者的去脂体重和四肢瘦体重（ALM）较少。在多变量模型中，ERA 组（-系数）（4.8，CI：2.6-8.8）、男性（7.7，CI：2.7-22.1）和脂肪质量指数（1.2，CI：1.1-1.4）与 IR 相关。胰岛素抵抗的 ERA 患者具有更高的炎症标志物和更高的疾病活动度。在 ERA 组的多变量模型中，IR 与男性（-系数）（7.4，CI：153-34.9）、高疾病活动度（6.2，CI：1.7-22.2）和较低的 ALM（0.03，CI：0.001-0.97）相关。IR 在大多数 RA 患者的早期阶段发展。IR 在男性中更为常见，与 RA 疾病活动度和较低的 ALM 相关。
