The metabolic profile in early rheumatoid arthritis: a high prevalence of metabolic obesity

Müller, Raili; Kull, Mart; Põlluste, Kaja; Aart, Annika; Eglit, Triin; Lember, Margus; Kallikorm, Riina

doi:10.1007/s00296-016-3464-9

Cited by 24 publications

(10 citation statements)

References 43 publications

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“…High BMI contributes to disease activity in RA by affecting both biomechanics and the metabolic status, and obese RA patients show worse subjective assessment of symptoms ( 79 ). Hyperglycemia, as a part of the metabolic syndrome, is more common in early RA ( 80 ), whereas active RA shows decreased lipid levels ( 81 ) despite an increased risk of CV events, due to the lipid-lowering effect of systemic inflammation ( 82 ). An increase in VAT, e.g., the epicardial fat ( 83 ), and the more abundant macrophage infiltrate are associated with systemic inflammation, metabolic syndrome, and IR ( 84 ).…”

Section: Obesity and Rheumatoid Arthritis (Ra): Evidences And Mechanimentioning

confidence: 99%

Aging, Obesity, and Inflammatory Age-Related Diseases

2017

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The increase in the prevalence of obesity represents a worldwide phenomenon in all age groups and is pathologically and genetically correlated with several metabolic and cardiovascular diseases, representing the most frequent age-related diseases. Obesity superimposed on aging drastically increases chronic low-grade inflammation (inflammaging), which is an important link between obesity, insulin resistance, and age-associated diseases. Immune cells of both the innate and the adaptive immune systems infiltrate the adipose tissue (AT) and during obesity induce inflammatory responses associated with metabolic switches and changes in phenotypes and function of immune cell subsets. Obesity poses new health problems especially when it occurs in the context of other diseases, many of them frequently affect elderly subjects. An emerging problem is the decreased proportion of patients with obesity achieving clinical response to therapy. In this review, we will discuss the reciprocal influences of immune cell and AT inflammation in aging and age-associated diseases and the complex relationship of nutrient and energy-sensing homeostatic checkpoints, which contribute to shape the phenotype of the AT. We will specifically examine type-2 diabetes, rheumatoid arthritis, osteoarthritis, cognitive impairment, and dementia, where obesity plays a significant role, also in shaping some clinical aspects.

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Section: Obesity and Rheumatoid Arthritis (Ra): Evidences And Mechanimentioning

confidence: 99%

Aging, Obesity, and Inflammatory Age-Related Diseases

2017

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“…These have largely focused on patients with established RA, and results may not be generalizable to ERA where initial disease activity, RA management algorithms, and screening/management of comorbidity may be different . The few studies exploring this topic in ERA have focused estimates of MetS in comparison with non‐RA controls only and have not explored sex‐specific variations in MetS components and associated factors . Furthermore, no study has explored menopause and its impact on MetS for women with ERA.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Kuriya

Schieir

Valois³

et al. 2019

ACR Open Rheumatology

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on behalf of CATCH investigatorsObjective. Metabolic syndrome (MetS) prevalence in early rheumatoid arthritis (ERA) is conflicting. The impact of sex, including menopause, has not been described. We estimated the prevalence and factors associated with MetS in men and women with ERA.Methods. A cross-sectional study of the Canadian Early Arthritis Cohort (CATCH) was performed. Participants with baseline data to estimate key MetS components were included. Sex-stratified logistic regression identified baseline variables associated with MetS.Results. The sample included 1543 participants; 71% were female and the mean age was 54 (SD 15) years. MetS prevalence was higher in men 188 (42%) than women 288 (26%, P < 0.0001) and increased with age. Frequent MetS components in men were hypertension (62%), impaired glucose tolerance (IGT, 40%), obesity (36%), and low high-density lipoprotein cholesterol (36%). Postmenopausal women had greater frequency of hypertension (65%), IGT (32%), and high triglycerides (21%) compared with premenopausal women (P < 0.001). In multivariate analysis, MetS was negatively associated with seropositivity and pulmonary disease in men. Increasing age was associated with MetS in women. In postmenopausal women, corticosteroid use was associated with MetS. Psychiatric comorbidity was associated with MetS in premenopausal women. MetS status was not explained by disease activity or core RA measures.Conclusion. The characteristics and associations of MetS differed in men and women with ERA. Sex differences, including postmenopausal status, should be considered in comorbidity screening. With this knowledge, the interplay of MetS, sex, and RA therapeutic response on cardiovascular outcomes should be investigated.

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“…Следует учитывать, что частота ИР, как и частота СД 2-го типа, различается в разных странах и регионах из-за генетических особенностей, традиционных диетических предпочтений и образа жизни. По данным литературы, частота ИР при РА колеблется от 53 до 89% [12][13][14][15], что значительно выше, чем в представленной работе. Возможно, это обусловлено применением менее жестких критериев для определения ИР.…”

Section: Discussionunclassified

“…Мы не выявили корреляции ИР с активностью РА, СОЭ и уровнем СРБ, возможно, из-за небольшого размера выборки, хотя в большинстве работ подобная взаимосвязь была прослежена [12][13][14][15][17][18][19]. Однако в нескольких исследованиях у больных ранним и развернутым РА активность воспаления не оказывала существенного влияния на индекс НОМА-IR [13,20,21].…”

Section: Discussionunclassified

Insulin resistance in rheumatoid arthritis: relationship to lipid metabolism disorders and metabolic syndrome

Кондратьева¹,

Попкова²,

Nasonov

2019

Naučno-praktičeskaâ revmatologiâ

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Objective:to determine the incidence of insulin resistance (IR) in patients with rheumatoid arthritis (RA) and to assess the relationship of IR to blood lipid profile changes and the presence of metabolic syndrome (MS).Subjects and methods.The investigation enrolled 47 RA patients (41 women and 6 men) without a history of diabetes mellitus (DM) and with normal fasting glucose levels during examination. The patients' median age was 56 [39; 62] years; disease duration – 6 [5; 14] years. Most of the patients had low (40.4%) or moderate (42.6%) RA activity (DAS28). IR was diagnosed using the Homeostastic Model Assessment of Insulin Resistance (HOMA-IR) index 2.77. The presence of MS was assessed by the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATPIII) criteria and the International Diabetes Federation (IDF) criteria.Results and discussion.The median HOMA-IR value in RA patients was 1.7 [1.1; 3.2]. The HOMA-IR index correlated with age (r=0.3; p=0.04), body mass index (r=0.6; p<0.001), waist circumference (r=0.6; p<0.001), and the concentrations of total cholesterol (r=0.3; p=0.02) and triglycerides (TG) (r=0.5; p<0.001). All the patients were divided into two groups: 1) 15 patients with IR; 2) 32 patients without IR. The patients of both groups were matched for sex, age, RA duration and activity, and therapy, but the RA patients with IR more often had abdominal obesity (100.0 and 37.5%), hypertriglyceridemia (33.3 and 6.3%) and the atherogenic index >3.0 (40.0 and 6.3%, respectively; p<0.05 in all cases). MS was diagnosed using the NCEP/ATPIII criteria in 46.7% of cases with RI and in 6.3% of those without IR; MS was identified by the IDF criteria in 60.0 and 12.5% of cases, respectively (p<0.01 in all cases). There were no differences between groups in the incidence of hypertension, myocardial infarction, or in the frequency of surgeries for myocardial revascularization.Conclusion.More than 30% of RA patients without DM have IR (HOMA-IR ≥2.77). IR in RA is associated with obesity, elevated blood TG levels, and a proatherogenic lipid profile. The use of the criteria for MS could not always allows suspect IR in patients with RA.

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The metabolic profile in early rheumatoid arthritis: a high prevalence of metabolic obesity

Cited by 24 publications

References 43 publications

Aging, Obesity, and Inflammatory Age-Related Diseases

Aging, Obesity, and Inflammatory Age-Related Diseases

Prevalence and Characteristics of Metabolic Syndrome Differ in Men and Women with Early Rheumatoid Arthritis

Insulin resistance in rheumatoid arthritis: relationship to lipid metabolism disorders and metabolic syndrome

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