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Rev Bras Reumatol Engl Ed. 2017 Jul - Aug;57(4):320-329. doi: 10.1016/j.rbre.2017.01.008. Epub 2017 Feb 15.

Obesity is the main determinant of insulin resistance more than the circulating pro-inflammatory cytokines levels in rheumatoid arthritis patients.

[Article in English, Portuguese]

Author information

1
Laboratorio de Biomedicina, Unidad Académica Multidisciplinaria Zona Media, Universidad Autónoma de San Luis Potosí, San Luís Potosí, México. Electronic address: jesus.castillo@uaslp.mx.
2
Laboratorio de Biomedicina, Unidad Académica Multidisciplinaria Zona Media, Universidad Autónoma de San Luis Potosí, San Luís Potosí, México.
3
Laboratorio de Investigación Clínica, Facultad de Estomatología, Universidad Autónoma de San Luis Potosí, San Luís Potosí, México.
4
Laboratorio de Medicina Nuclear, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luís Potosí, México.
5
Laboratorio de Biomedicina, Unidad Académica Multidisciplinaria Zona Huasteca, Universidad Autónoma de San Luis Potosí, San Luís Potosí, México.

Abstract

BACKGROUND:

Systemic blockade of TNF-α in Rheumatoid arthritis with insulin resistance seems to produce more improvement in insulin sensitivity in normal weight patients with Rheumatoid arthritis than in obese patients with Rheumatoid arthritis, suggesting that systemic-inflammation and obesity are independent risk factors for insulin resistance in Rheumatoid arthritis patients.

OBJECTIVES:

To evaluate the insulin resistance in: normal weight patients with Rheumatoid arthritis, overweight patients with Rheumatoid arthritis, obese Rheumatoid arthritis patients, and matched control subjects with normal weight and obesity; and its association with major cytokines involved in the pathogenesis of the disease.

METHODS:

Assessments included: body mass index, insulin resistance by Homeostasis Model Assessment, ELISA method, and enzymatic colorimetric assay.

RESULTS:

Outstanding results from these studies include: (1) In Rheumatoid arthritis patients, insulin resistance was well correlated with body mass index, but not with levels of serum cytokines. In fact, levels of cytokines were similar in all Rheumatoid arthritis patients, regardless of being obese, overweight or normal weight (2) Insulin resistance was significantly higher in Rheumatoid arthritis with normal weight than in normal weight (3) No significant difference was observed between insulin resistances of Rheumatoid arthritis with obesity and obesity (4) As expected, levels of circulating cytokines were significantly higher in Rheumatoid arthritis patients than in obesity.

CONCLUSIONS:

Obesity appears to be a dominant condition above inflammation to produce IR in RA patients. The dissociation of the inflammation and obesity components to produce IR suggests the need of an independent therapeutic strategy in obese patients with RA.

KEYWORDS:

Artrite reumatoide; Insulin resistance; Obesidade; Obesity; Resistência à insulina; Rheumatoid arthritis; TNF-α

PMID:
28743359
DOI:
10.1016/j.rbre.2017.01.008
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