Chronic inflammation is associated with impaired glucose tolerance and insulin resistance (IR) phenomenon. Proinflammatory cytokines such as interleukin-6 and tumor necrosis factorTNF-α play a significant role in the pathogenesis of rheumatoid arthritis (RA) and ankylosing spondylitis (AS). However, the relationships between prevalence of IR and metabolic syndrome (MetS) in patients (pts) with a different rheumatic diseases have not been yet well characterized.
The study was conducted in 102 pts aged 18-65 years, including 60 pts with RA (45 women, 15 men) and 42 pts with AS (4 women, 38 men). In all of pts serum fasting hemoglobin (Hb), fibrinogen, uric acid, vitamin D3, lipids, ESR, CRP, IL-6, hs-CRP, SAA, IL-6 sR, RF-IgM titer, a-CCP, and glucose, insulin after 0, 30, 60, 120 min during the oral glucose tolerance test with the calculation of indicators of IR (HOMA-IR, insulin/glucose) and insulin sensitivity (QUICKI, Matsuda) were performed. Moreover, BMI, WHR, disease activity indices (DAS28 in RA, BASDAI in AS) and the criteria for diagnosis of MetS were evaluated. The results were statistically analyzed.
IR and MetS occur more frequently in patients with RA. Forthese disorders a strongly correlation with BMI and WHR, whereas not with disease activity indices has been shown. RA patients with MetS had a higher titers of RF-IgM and hemoglobin concentration.
Patients with RA have an increased risk of MetS with IR compared to patients with AS. In addition, higher RF-IgM titer increases the risk of developing MetS in RA.