FRI0076 What Inflammatory Marker Best Reflects Insulin Resistance in Rheumatoid Arthritis?
Authors: F. Ursini, S. Naty, C. Bruno, L. D'Antona, C. Tripolino, K. Nicolosi, M. Rubino, F. Savarino, R.D. Grembiale
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Rheumatoid arthritis (RA) is characterized by an increased cardiovascular diseases (CVD) risk, estimated to be about 50% greater when compared to the general population[1]. Insulin resistance (IR), a key feature of the Metabolic Syndrome (MS) represents a well-recognized independent cardiovascular risk factor. RA has been epidemiologically correlated with an elevated prevalence of MS[2] independently of corticosteroids exposure[3], and the coexistence of RA with MS appears to be associated with a higher disease activity[4]. <h3>Objectives</h3> Aim of this work was to examine the correlation between measures of inflammation and IR in RA patients. <h3>Methods</h3> Height, weight and waist circumference (WC) were measured and Body Mass Index (BMI) was calculated with the standard formula. DAS28-CRP was used to evaluate disease activity. After overnight fasting, blood samples were obtained for laboratory evaluation including: complete blood count, plasma glucose, insulin, ferritin, erythrocyte sedimentation rate (ESR), High Sensitivity-CRP. Insulin resistance was estimated with the indirect measure Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Paired samples Student9s t-test was used to compare means. The Pearson product-moment correlation coefficient was used to evaluate correlation between variables. Continuous variables that were not normally distributed were <i>ln</i>-transformed before analysis. A <i>p</i>-value &lt;0.05 was considered statistically significant. <h3>Results</h3> For the present study 100 RA patients (44 males, 56 females) and 100 age- and sex matched controls were recruited. Patients tended to be overweight and with a higher waist circumference compared to controls. In univariate correlational analysis HOMA-IR correlated significantly with <i>age</i> (r=0.34, p=0.001), <i>BMI</i> (r=0.69, p&lt;0.0001), <i>WC</i> (r=0.66, p&lt;0.0001), <i>DAS28-CRP</i> (r=0.25, p 0.02), <i>ln(hs-CRP)</i> (r=0.39, p=0.0002), <i>ESR</i> (r=0.43, p&lt;0.0001), <i>complement C3</i> (r=0.36, p=0.0006) and <i>ln(Ferritin)</i> (r=0.26, p=0.01). In controls, HOMA-IR correlated only with measures of obesity but not with inflammatory markers. <h3>Conclusions</h3> In the present study we demonstrated that in RA patients, but not in controls, the indirect measure of insulin resistance HOMA-IR correlates with measures of inflammations. In this context, ESR is the single best parameter reflecting insulin resistance. <h3>References</h3> Avina-Zubieta JA, Thomas J, Sadatsafavi M, Lehman AJ, Lacaille D: Risk of incident cardiovascular events in patients with rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis 2012, 71:1524-1529. Zhang J, Fu L, Shi J, Chen X, Li Y, Ma B, Zhang Y: The risk of metabolic syndrome in patients with rheumatoid arthritis: a meta-analysis of observational studies. PLoS One 2013, 8:e78151. Toms TE, Panoulas VF, Douglas KM, Griffiths HR, Kitas GD: Lack of association between glucocorticoid use and presence of the metabolic syndrome in patients with rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2008, 10:R145. da Cunha VR, Brenol CV, Brenol JC, Fuchs SC, Arlindo EM, Melo IM, Machado CA, de Castro Chaves H, Jr., Xavier RM: Metabolic syndrome prevalence is increased in rheumatoid arthritis patients and is associated with disease activity. Scand J Rheumatol 2012, 41:186-191. <h3>Disclosure of Interest</h3> None declared