Insulin Resistance in Early Rheumatoid Arthritis Is Associated with Low Appendicular Lean Mass

In established rheumatoid arthritis (RA), the presence of insulin resistance (IR) is well proven but, in the early stage of the disease, data are inconclusive. We evaluated the presence of IR and associations with body composition (BC) parameters among early RA (ERA) and control subjects. The study...

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Bibliographic Details
Published in:BioMed research international 2017-01, Vol.2017 (2017), p.1-8
Main Authors: Valner, Annika, Põlluste, Kaja, Lember, Margus, Kull, Mart, Müller, Raili, Kallikorm, Riina
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Arthritis
Arthritis, Rheumatoid - blood
Arthritis, Rheumatoid - pathology
Arthritis, Rheumatoid - physiopathology
Atherosclerosis
Bioindicators
Biomarkers - blood
Body composition
Body fat
Body Mass Index
Cardiovascular disease
Clinical medicine
Diabetes
Fat-free body mass
Female
Gender
Health risk assessment
Humans
Inflammation
Insulin
Insulin Resistance
Male
Males
Mathematical models
Metabolism
Middle Aged
Mortality
Obesity
Observations
Patients
Physiological aspects
Population
Primary care
Rheumatic diseases
Rheumatoid arthritis
Rheumatology
Sarcopenia
Sex Characteristics
Tumor necrosis factor-TNF
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Summary:In established rheumatoid arthritis (RA), the presence of insulin resistance (IR) is well proven but, in the early stage of the disease, data are inconclusive. We evaluated the presence of IR and associations with body composition (BC) parameters among early RA (ERA) and control subjects. The study group consisted of 92 ERA and 321 control subjects. Using homeostatic model assessment of IR (HOMA-IR), the cut-off value for IR was 2.15. 56% of the ERA patients and 25% of the controls had IR. Of the BC parameters, patients with early RA had less fat-free mass and appendicular lean mass (ALM). In multivariable model, ERA group (b-Coefficient) (4.8, CI: 2.6–8.8), male gender (7.7, CI: 2.7–22.1), and fat mass index (1.2, CI: 1.1–1.4) were associated with IR. Insulin-resistant ERA patients had higher inflammatory markers and higher disease activity. In the multivariable model in the ERA group, IR was associated with male gender (b-Coefficient) (7.4, CI: 153–34.9), high disease activity (6.2, CI: 1.7–22.2), and lower ALM (0.03, CI: 0.001–0.97). IR develops in the early stage of RA in the majority of patients. IR is more common among males and is associated with RA disease activity and lower ALM.
ISSN:2314-6133
2314-6141
DOI:10.1155/2017/9584720