Rheumatology and Rehabilitation Department, Al-Azhar University, Cairo, Egypt.
Internal Medicine Department, Al-Azhar University, Cairo, Egypt.
Curr Rheumatol Rev. 2024;20(2):191-199. doi: 10.2174/0115733971259984230922054439.
In rheumatoid arthritis (RA), insulin resistance (IR) is related to inflammatory markers, disease activity, and progression of atherosclerotic changes. Triglyceride-glucose (TyG) index is a relatively new indicator of IR.
The present study aimed to investigate the relationship between TyG index, disease activity and subclinical atherosclerosis (SCA) in RA patients.
The present case-control study included 100 RA patients and 50 age- and sex-matched healthy controls. All participants were subjected to careful history taking through clinical examination and standard laboratory assessment. The TyG index was calculated as TyG index = ln (Fasting triglyceride (mg/dL) × fasting glucose (mg/dL))/2. Carotid intima-media thickness (CIMT) measurement was done using B-mode ultrasound.
Patients had significantly higher TyG index as compared to controls. Patients with high disease activity had significantly higher frequency of extraarticular manifestations (39.6% 51.6%, p = 0.028), higher Larsen score (3.8 ± 1.3 2.8 ± 1.2, < 0.001), higher anti-cyclic citrullinated peptide (anti-CCP) levels (median (IQR): 243.1 (205.0-408.0) U/ml 99.0 (78.0-332.5), < 0.001), higher TyG index (4.8 ± 0.22 4.67 ± 0.24, = 0.006), and higher CIMT (0.87 ± 0.22 0.77 ± 0.17 mm, = 0.018). Patients with SCA had higher BMI (34.6 ± 6.2 30.5 ± 5.3 Kg/m, < 0.001), higher Larsen score (3.7 ± 1.4 3.1 ± 1.3, = 0.028) and higher TyG index (4.89 ± 0.23 4.64 ± 0.19, < 0.001). Binary logistic regression analysis identified patients' age (OR (95% CI): 0.94 (0.89-0.99), = 0.018), Larsen score (OR (95% CI): 1.93 (1.32-2.82), p = <0.001), anti-CCP (OR (95%): 1.04 (1.02-1.07), = 0.032), and TyG index (OR (95% CI): 22.67 (2.14-240.4), = 0.01) as significant predictors of high disease activity in multivariate analysis.
IR estimated by the TyG index is related to disease activity and SCA in RA patients.
在类风湿关节炎（RA）中，胰岛素抵抗（IR）与炎症标志物、疾病活动度和动脉粥样硬化变化的进展有关。甘油三酯-葡萄糖（TyG）指数是一种新的 IR 指标。
本研究旨在探讨 RA 患者的 TyG 指数与疾病活动度和亚临床动脉粥样硬化（SCA）之间的关系。
本病例对照研究纳入了 100 例 RA 患者和 50 名年龄和性别匹配的健康对照者。所有参与者均通过临床检查和标准实验室评估进行详细的病史采集。TyG 指数的计算方法为 TyG 指数=ln（空腹甘油三酯（mg/dL）×空腹血糖（mg/dL））/2。采用 B 型超声测量颈动脉内膜中层厚度（CIMT）。
与对照组相比，患者的 TyG 指数显著升高。高疾病活动度患者的关节外表现发生率明显更高（39.6%比 51.6%，p=0.028），Larsen 评分更高（3.8±1.3 比 2.8±1.2，<0.001），抗环瓜氨酸肽（抗-CCP）水平更高（中位数（IQR）：243.1（205.0-408.0）U/ml 比 99.0（78.0-332.5）U/ml，<0.001），TyG 指数更高（4.8±0.22 比 4.67±0.24，=0.006），CIMT 更高（0.87±0.22 比 0.77±0.17 mm，=0.018）。SCA 患者的 BMI 更高（34.6±6.2 比 30.5±5.3 kg/m，<0.001），Larsen 评分更高（3.7±1.4 比 3.1±1.3，=0.028），TyG 指数更高（4.89±0.23 比 4.64±0.19，<0.001）。二元逻辑回归分析确定了患者的年龄（OR（95%CI）：0.94（0.89-0.99），=0.018）、Larsen 评分（OR（95%CI）：1.93（1.32-2.82），p<0.001）、抗-CCP（OR（95%）：1.04（1.02-1.07），=0.032）和 TyG 指数（OR（95%CI）：22.67（2.14-240.4），=0.01）是多变量分析中疾病活动度高的显著预测因素。
TyG 指数估计的 IR 与 RA 患者的疾病活动度和 SCA 有关。
