Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis

Dessein, Patrick H; Stanwix, Anne E.; Joffe, B. I.

doi:10.1186/ar428

Cited by 156 publications

(35 citation statements)

References 15 publications

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“…Drugs that decrease insulin resistance (metformin and thiazolidinediones) and altered life style reduce hyperglycemia and improve blood pressure and lipid profile. Previous studies have shown an increased risk of atherosclerosis in patients with inflammatory diseases such as systemic lupus erythematosus and rheumatoid arthritis [4,5,6]. Our study demonstrates that patients with psoriasis have a significant association with each of the components of the metabolic syndrome.…”

Section: Discussionsupporting

confidence: 59%

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Association between Psoriasis and the Metabolic Syndrome

Cohen

Sherf²,

Vidavsky³

et al. 2008

Dermatology

255

230

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Background: Previous reports have shown an association between inflammatory diseases such as systemic lupus erythematosus or rheumatoid arthritis and the metabolic syndrome. Recent data demonstrate that psoriasis is an inflammatory disease, suggesting that psoriasis may be one of the components of the metabolic syndrome. Objective: To assess the association between psoriasis and the metabolic syndrome. Methods: A cross-sectional study was performed utilizing the database of the Clalit Health Services. Case patients were defined as patients with a diagnosis of psoriasis vulgaris. Controls were randomly selected from the list of Clalit Health Services enrollees. The proportions of components of the metabolic syndrome (ischemic heart disease, hypertension, diabetes, obesity and dyslipidemia) were compared between case and control patients by univariate analyses. χ² tests were used to compare categorical parameters between the groups. Logistic and linear regression models served to measure the association between psoriasis and the metabolic syndrome. Results: The study included 16,851 patients with psoriasis and 48,681 controls. In the case group, there were 8,449 men (50.1%) and 8,402 women (49.9%), with a mean age of 42.7 years (SD = 20.3, range = 2–111). Diabetes mellitus was present in 13.8% of the patients with psoriasis as compared to 7.3% of the controls (p < 0.001). Hypertension occurred in 27.5% of the patients with psoriasis and in 14.4% of the controls (p < 0.001). Obesity was present in 8.4% of the patients with psoriasis as opposed to 3.6% of the controls (p < 0.001). Ischemic heart disease was observed in 14.2% of the patients with psoriasis as compared to 7.1% of the controls (p < 0.001). Multivariate models adjusting for age, gender and smoking status of the patients demonstrated that psoriasis was associated with the metabolic syndrome (OR = 1.3, 95% CI = 1.1–1.4), ischemic heart disease (OR = 1.1, 95% CI = 1.0–1.2), diabetes mellitus (OR = 1.2, 95% CI = 1.0–1.3), hypertension (OR = 1.3, 95% CI = 1.2–1.5) and obesity (OR = 1.7, 95% CI = 1.5–1.9). Limitations: The study is designed as a case-control study, thus an association alone was proven and not causality. Conclusion: Our findings demonstrate a possible association between psoriasis and the metabolic syndrome. Appropriate treatment of the metabolic syndrome may be an important part of the management of patients with psoriasis.

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Section: Discussionsupporting

confidence: 59%

“…Systemic inflammation occurs in patients with the metabolic syndrome, which is evident as a number of inflammatory markers such as TNF are often increased [1,2,3]. Recent studies have demonstrated an association between inflammatory diseases such as systemic lupus erythematosus or rheumatoid arthritis and the metabolic syndrome [4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Association between Psoriasis and the Metabolic Syndrome

Cohen

Sherf²,

Vidavsky³

et al. 2008

Dermatology

255

230

View full text Add to dashboard Cite

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“…In fact, low HDL-C in autoimmune diseases including RA often negatively correlated with acute phase reactants including CRP and erythrocyte sedimentation rate, and further results also showed that these acute phase reactants are at least partially responsible for the presence of low HDL-C in RA [18]. The precise mechanisms remain to be established, however, inflammatory cytokines and acute phase reactants may act in adipose tissue, skeletal muscle and the liver to promote metabolic changes that result in lipoproteins abnormalities [19].…”

Section: Discussionmentioning

confidence: 81%

Altered Lipid Levels in Untreated Patients with Early Polymyositis

Wang

Cai

et al. 2014

PLoS ONE

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BackgroundLittle is known so far on the lipid profile in polymyositis (PM) patients. Our aim is to identify lipid profiles in untreated patients with early PM, to assess the association between lipid profiles and C-reactive protein (a sensitive marker of inflammation) in these patients.Methods and FindingsThis work was conducted as a case-control study. Sixty untreated patients with PM and 60 age- and sex-matched healthy controls were included. The duration of PM was less than six months, and none of them had received intermittent or regular corticosteroids or disease-modifying antirheumatic drugs or biological agents prior to the study. Triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), and HDL-cholesterol (HDL-C), and C-reactive protein (CRP) were assessed using standard techniques. Thirty patients (50%) had a decreased level of HDL-C and 47% had an increased level of TG. The levels of HDL-C, LDL-C, and TC in PM were significantly lower than in controls (P<0.001, P<0.01, P<0.001, respectively). The level of TG was significantly higher in PM than in controls (P<0.001). The level of very low LDL-cholesterol (VLDL-C), and the ratios of VLDL-C/LDL-C, TC/HDL-C, and LDL-C/HDL-C were significantly higher than in controls (all P<0.001). Serum CRP levels correlated negatively with HDL-C (r = −0.352, P = 0.006) and TC (r = −0.262, P = 0.043). After adjustment for age, gender, smoking, drinking, body mass index, and pulmonary fibrosis/infection, linear regression model demonstrated that CRP is associated with HDL-C among PM patients (P = 0.028).ConclusionsDyslipidemia is a common feature in patients with PM that is characterized by a decrease in HDL-C and an increase in TG, suggesting a high risk of atherosclerosis. The Inflammatory condition in PM may account for the metabolism of HDL-C.

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“…It is recognized that the pathogenesis of insulin resistance includes low-grade inflammation (16). It was reported that serum IL-18 levels might be a sensitive marker of the chronic inflammatory process underlying insulin resistance, especially in patients with type 2 diabetes (16,34). In addition, the authors hypothesized that plasma levels of IL-18 would be a superior marker of insulin resistance when compared to IL-6, TNF-α, sTNFR2, and CRP.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the authors hypothesized that plasma levels of IL-18 would be a superior marker of insulin resistance when compared to IL-6, TNF-α, sTNFR2, and CRP. Patients with autoimmune connective tissue diseases also have increased insulin resistance (32), and it was reported to be associated with inflammation and glucocorticoid therapy in RA (34). The associations between acute-phase responses and insulin resistance are well documented in RA (35).…”

Section: Discussionmentioning

confidence: 99%

Potential role of interleukin-18 in patients with rheumatoid arthritis-associated carotid intima-media thickness but not insulin resistance

et al. 2014

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Objective: Plasma interleukin-18 (IL-18) has been reported to be associated with homeostasis model assessment of insulin resistance (HOMA-IR). It also has been described as one of the factors that, in addition to insulin resistance, may also contribute to atherosclerosis. Parameters of systemic inflammation are also significantly associated with circulating IL-18. Our objective was to investigate whether IL-18 is associated with insulin resistance and atherosclerosis in patients with rheumatoid arthritis (RA) in which accelerated atherogenesis develops.Material and Methods: Fifty-one female RA patients and 30 female controls were enrolled in the study; 31 of them were without diseasemodifying antirheumatic drug (DMARD) treatment and had a relatively short disease duration. Disease activity was assessed by Disease Activity Score (DAS) 28 index. HOMA-IR method was used to detect insulin resistance. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fasting plasma glucose (FPG), insulin, tumor necrosis factor alpha (TNF-α), and IL-18 levels were evaluated. Also, carotid intima-media thickness (cIMT) was measured.Results: There were no differences between patients and the control group according to age, sex, and body mass index. ESR, CRP, insulin, FPG, HOMA-IR, TNF-α, IL-18 levels, and cIMT measurements were significantly high in the patient group. HOMA-IR and cIMT measurements were similar and high in both the DMARD and non-DMARD patient groups. HOMA-IR correlated with TNF-α (r=0.308, p=0.028), but no correlation was found between IL-18 and HOMA-IR. However, IL-18 was correlated positively with cIMT (r= 0.318, p=0.028) and negatively with BMI (r=-0.360, p=0.01).Conclusion: IL-18 is associated with atherosclerosis in RA patients. However, no significant relation was found with insulin resistance. IL-18 may be a marker for early evaluation of atherosclerosis in RA patients.

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Cardiovascular risk in rheumatoid arthritis versus osteoarthritis: acute phase response related decreased insulin sensitivity and high-density lipoprotein cholesterol as well as clustering of metabolic syndrome features in rheumatoid arthritis

Cited by 156 publications

References 15 publications

Association between Psoriasis and the Metabolic Syndrome

Association between Psoriasis and the Metabolic Syndrome

Altered Lipid Levels in Untreated Patients with Early Polymyositis

Potential role of interleukin-18 in patients with rheumatoid arthritis-associated carotid intima-media thickness but not insulin resistance

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