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oai:repisalud.isciii.es:20.500.12105/182492024-09-21T23:50:01Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16927

00925njm 22002777a 4500 dc Manrique-Arija, Sara author Mena-Vazquez, Natalia author Ureña, Inmaculada author Rioja, José author Valdivielso, Pedro author Ginel-Mendoza, Leovigildo author Abad-Sánchez, Salomé author Jiménez-Núñez, Francisco G author Oliver-Martos, Begoña author Fernandez-Nebro, Antonio author 2021-02-09 To describe the prevalence of insulin resistance (IR) in patients with established rheumatoid arthritis (RA) and to analyse the contribution of cumulative inflammatory burden and other factors to its development. Observational cross-sectional study. Patients with RA and controls matched for age, sex and Body Mass Index. We excluded patients with diabetes. Patients from an RA inception cohort at Hospital Regional Universitario de Málaga, Spain, were recruited between September 2016 and May 2018. IR was evaluated using the homeostasis model assessment for IR and beta-cell function and the quantitative insulin sensitivity check index. Other variables included the cumulative 28-Joint Disease Activity Score (DAS28) with C reactive protein (CRP) body composition and cytokines. Two logistic regression models were constructed to identify factors associated with IR in patients with RA. Eighty-nine patients with RA and 80 controls were included. The prevalence of IR was similar in both cases and controls. Inflammatory activity was controlled appropriately in patients during follow-up (mean DAS28 3.1 (0.8)). The presence of IR in patients with RA was associated with obesity (OR 6.01, 95% CI 1.9 to 8.7), higher cumulative DAS28-CRP values during follow-up (OR 2.8, 95% CI 1.3 to 6.0), and higher interleukin-1β levels (OR 1.6, 95% CI 1.1 to 2.4). The second model showed that the risk of IR increased by 10% for each kilogram of excess body fat. In patients with well-controlled, established RA, IR is associated mainly with poorer control of inflammation from diagnosis and with obesity, specifically total fat mass. 10.1136/bmjopen-2020-044749 2044-6055 BMJ open http://hdl.handle.net/10668/17136 33563625 http://hdl.handle.net/20.500.12105/18249 diabetes & endocrinology rheumatology Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: cross-sectional study.