Low prevalence of rheumatoid arthritis among patients with pre-existing type 2 diabetes mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a non-autoimmune disease characterized by chronic hyperglycemia and increased non-enzymatic glycation of amino groups. Glycation occurs through a series of events eventually leading to the formation of irreversible "advanced glycation end-products" (AGEs). AGEs may affect the function of long-lived proteins, including cytokines, immunoglobulins and their receptors, resulting in a "less active" immune system. We aimed to test the hypothesis that a common inflammatory chronic disease, such as rheumatoid arthritis (RA), in which the earliest event is an inflammatory response to unknown stimulus, has a lower prevalence in these patients than in normoglycemic, non-diabetic subjects. Methods: In this study, we compared the prevalence of RA in a prospectively followed outpatient cohort of patients with T2DM patients (n=1,630) with a control, matched, non-diabetic population (n=1,630). Results: Among non-diabetic controls, 13 patients (prevalence 0.80%) with RA were identified. An almost 3-fold lower prevalence of RA (0.25%) was found in consecutive patients with T2DM (P=0.029). Most of the RA cases among participants with T2DM were diagnosed early after diabetes onset. The onset of RA in patients with T2DM occurred at significantly older age (64±15 years) as compared to the non-diabetes group (48±18 years; P=0.004). Conclusions: The prevalence of RA is lower and occurs in an older age in patients with pre-existing T2DM in comparison with people without T2DM.

Menopausal factors and risk of seropositive rheumatoid arthritis in postmenopausal women: a nationwide cohort study of 1.36 million women

“…www.nature.com/scientificreports/ Co-morbidities of diabetes and cancer were related to lower risk of seropositive RA. This is in agreement with a recent case-control study conducted in Greece demonstrating low prevalence in patients with type 2 diabetes 42 and a nationwide population-based cohort study in Taiwan showing the relationship between female breast cancer and lower RA risk 43 . The mechanism by which the risk of RA is lowered in cancer patients is not clear, but the high activity of regulatory T cells seen in cancer patients may contribute [44][45][46] .…”

Systemic and ocular diseases associated with the development of diabetic macular edema among Japanese patients with diabetes mellitus

“…Furthermore, female patients with DM are more likely to report very irregular menstrual cycles [39]. Although the present study identified arthritis as a risk factor for developing DME, Tentolouris et al found a negative correlation between arthritis and DM [40].…”

Review: Roles of human serum albumin in prediction, diagnoses and treatment of COVID-19

“…Acute hyperglycaemia likewise disables neutrophil phagocytosis and bactericidal activity [111] , [114] , [115] , respiratory burst capacity [116] , [117] and development of granular elastase and myeloperoxidase extracellular traps leading to susceptibility to infection [118] . Acute hyperglycaemia has additionally been related to decreased complement fixation and opsonization of microorganisms [119] . Suppression of cytokine synthesis by peripheral blood mononuclear cells and monocytes isolated from people with diabetes has been accounted for [70] .…”