title: Insulin resistance and levels of adipokines in patients with untreated early rheumatoid arthritis.
abstract: The aim of this study is to investigate the presence of insulin resistance (IR) in patients with untreated early rheumatoid arthritis (ERA) and its relationship with adipokines, inflammatory cytokines, and treatment. In this prospective study, we enrolled 46 ERA patients with a disease duration of <1 year, and 45 sex-, age-, race-, and body mass index (BMI)-matched controls. Patients and controls with diabetes or a history of glucocorticoid (GC) or disease-modifying antirheumatic drugs (DMARDs) use were excluded. Patients were assessed at the time of diagnosis (visit 1) and after 6 months of treatment (visit 2). The main outcomes were homeostatic model assessment of IR (HOMA-IR) and β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). A multivariate regression analysis was performed to analyze IR adjusting according to lipids, body composition, physical activity, nutrition, and inflammatory cytokine and adipokine levels. The baseline HOMA-IR, HOMA-β, and QUICKI values were similar in both groups. However, patients showed lower levels of physical activity, total cholesterol, and high-density lipoprotein. Moreover, the inflammatory cytokines and resistin concentrations were higher in patients than controls. Multivariate analysis indicated that BMI and baseline rheumatoid factor levels were positively associated with HOMA-IR and HOMA-β, and negatively with QUICKI. After DMARD treatment, patients showed improvements in inflammatory parameters and lipids whereas IR remained stable. Furthermore, adiponectin and resistin concentrations decreased slightly. Our data suggest that IR is not present in ERA patients either at diagnosis or at 6 months after treatment. However, symptom duration and fat mass appear to be related.
authors.affiliation: UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Manrique-Arija
authors.affiliation: UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ureña
authors.affiliation: UGC de Medicina Interna, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Valdivielso
authors.affiliation: Departamento de Medicina y Dermatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Rioja
authors.affiliation: UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.
authors.forename: Francisco G
authors.initials: FG
authors.lastname: Jiménez-Núñez
authors.affiliation: UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain.
authors.forename: María V
authors.initials: MV
authors.lastname: Irigoyen
authors.affiliation: UGC de Reumatología, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario de Málaga, Universidad de Málaga, Málaga, Spain. afernandezn@uma.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Nebro
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood*; D015992:Body Mass Index; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D011446:Prospective Studies; D052243:Resistin / Q000097:blood*; D013030:Spain
chemical_list: D054392:Adipokines; D016207:Cytokines; C499624:RETN protein, human; D052243:Resistin
keywords: Adipokines; DMARDs; Early rheumatoid arthritis; Insulin resistance