Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Curr Med Res Opin. 2019 Dec;35(12):2197-2205. doi: 10.1080/03007995.2019.1654988. Epub 2019 Sep 13.
Rheumatoid arthritis (RA) is a chronic inflammatory joint disease characterized by an altered glucose and lipid metabolism. Tumor necrosis factor alpha (TNF-) is involved in the pathogenesis of both RA and metabolic syndrome. This study evaluated the effects of anti-TNF- agents (adalimumab, etanercept, infliximab) on lipid and glucose metabolism in patients with RA. A total of 33 RA, biological therapy- patients were recruited. Changes in Disease Activity, Body Mass Index, resistin, leptin and adiponectin serum levels, lipid profile, atherogenic index, insulin sensitivity index, and insulin resistance index were evaluated at baseline and after anti-TNF- treatments. Anti-TNF- treatment was effective in reducing disease activity. An inverse relationship between disease activity and adiponectin levels was found, whereas leptin and resistin levels directly correlated with disease activity. TNF- therapy significantly reduced leptin, resistin, and increased adiponectin. TNF- inhibition resulted in a reduction of atherogenic index and insulin resistance index while increased insulin sensitivity index. Anti-TNF- agents could have a crucial role in modifying the impact of lipid profile and glucose levels dysregulation in RA patients. TNF- inhibition may be a potential strategy for the prevention of metabolic syndrome and could play a role in the reduction of cardiovascular risk in RA.
类风湿关节炎（RA）是一种慢性炎症性关节疾病，其特征是葡萄糖和脂质代谢发生改变。肿瘤坏死因子-α（TNF-α）参与了 RA 和代谢综合征的发病机制。本研究评估了抗 TNF-α 药物（阿达木单抗、依那西普、英夫利昔单抗）对 RA 患者脂质和糖代谢的影响。共招募了 33 名 RA、生物治疗患者。在基线和抗 TNF-α 治疗后评估疾病活动度、体重指数、抵抗素、瘦素和脂联素血清水平、血脂谱、致动脉粥样硬化指数、胰岛素敏感性指数和胰岛素抵抗指数的变化。抗 TNF-α 治疗可有效降低疾病活动度。发现疾病活动度与脂联素水平呈负相关，而瘦素和抵抗素水平与疾病活动度直接相关。TNF-α 治疗显著降低了瘦素、抵抗素，增加了脂联素。TNF-α 抑制导致致动脉粥样硬化指数和胰岛素抵抗指数降低，而胰岛素敏感性指数增加。抗 TNF-α 药物在调节 RA 患者脂质谱和血糖水平失调方面可能具有重要作用。TNF-α 抑制可能是预防代谢综合征的一种潜在策略，并可能在降低 RA 患者的心血管风险方面发挥作用。
