title: Influence of Insulin Resistance and TNF-α on the Inflammatory Process, Oxidative Stress, and Disease Activity in Patients with Rheumatoid Arthritis.
abstract: The aim of this study was to evaluate the involvement of TNF-α and insulin resistance (IR) in the inflammatory process, oxidative stress, and disease activity in patients with rheumatoid arthritis (RA). This cross-sectional study included 270 subjects (control group, n = 97) and RA patients (n = 173). RA patients were divided into four groups: the first group without IR and not using antitumor necrosis factor-α (TNF-) (G1, IR- TNF-); the second group without IR and using anti-TNF-α (G2, IR- TNF+); the third group with IR and not using anti-TNF-α (G3, IR+ TNF-); and the fourth group with IR and using anti-TNF-α (G4, IR+ TNF+). G3 and G4 had higher (p < 0.05) advanced oxidation protein products (AOPPs) and oxidative stress index (OSI) compared to G1. G4 group presented higher (p < 0.05) AOPPs and OSI than G2. TRAP was significantly lower in G3 compared to G1. Plasma TNF-α levels were significantly higher in G4 and G2 compared to G1 (p < 0.0001) and G3 (p < 0.0001 and p < 0.01, resp.). The presence of insulin resistance was robustly associated with both oxidative stress and TNF-α levels. More studies are warranted to verify if IR can be involved in therapeutic failure with TNF-α inhibitors. This trial is registered with Brazilian Clinical Trials Registry Register number RBR-2jvj92.
authors.affiliation: Department of Rheumatology, University of Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Neide Tomimura
authors.identifier: 0000-0001-6624-2043
authors.initials: NT
authors.lastname: Costa
authors.affiliation: Department of Rheumatology, University of Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Tatiana Mayumi
authors.identifier: 0000-0002-0801-3098
authors.initials: TM
authors.lastname: Veiga Iriyoda
authors.affiliation: Department of Clinical Analysis, University North of Paraná (UNOPAR), Londrina, PR, Brazil.
authors.forename: Ana Paula
authors.identifier: 0000-0001-9563-971X
authors.initials: AP
authors.lastname: Kallaur
authors.affiliation: Department of Clinical Pathology, University of Londrina, Robert Koch Avenue No. 60 Bairro Cervejaria, Londrina 86038-440, PR, Brazil.
authors.forename: Francieli
authors.initials: F
authors.lastname: Delongui
authors.affiliation: Department of Clinical Pathology, University of Londrina, Robert Koch Avenue No. 60 Bairro Cervejaria, Londrina 86038-440, PR, Brazil.
authors.forename: Daniela Frizon
authors.initials: DF
authors.lastname: Alfieri
authors.affiliation: Department of Clinical Pathology, University of Londrina, Robert Koch Avenue No. 60 Bairro Cervejaria, Londrina 86038-440, PR, Brazil.
authors.forename: Marcell Alysson Batisti
authors.initials: MA
authors.lastname: Lozovoy
authors.affiliation: Department of Rheumatology, University of Londrina (UEL), Londrina, PR, Brazil.
authors.forename: Ricardo Braga
authors.initials: RB
authors.lastname: Amin
authors.affiliation: Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil.
authors.forename: Vinicius Daher Alvares
authors.identifier: 0000-0002-5443-9348
authors.initials: VD
authors.lastname: Delfino
authors.affiliation: Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil.
authors.forename: Isaias
authors.initials: I
authors.lastname: Dichi
authors.affiliation: Department of Clinical Pathology, University of Londrina, Robert Koch Avenue No. 60 Bairro Cervejaria, Londrina 86038-440, PR, Brazil.
authors.forename: Andréa Name Colado
authors.initials: AN
authors.lastname: Simão
mesh_terms: D000328:Adult; D062107:Advanced Oxidation Protein Products / Q000097:blood; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000097:blood* / Q000276:immunology; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D010084:Oxidation-Reduction; D018384:Oxidative Stress / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000097:blood* / Q000276:immunology
chemical_list: D062107:Advanced Oxidation Protein Products; D018501:Antirheumatic Agents; D015415:Biomarkers; D001786:Blood Glucose; D018836:Inflammation Mediators; D007328:Insulin; D014409:Tumor Necrosis Factor-alpha