Clinical evaluation of insulin resistance and ?-cell function by the homeostasis model assessment in patients with systemic lupus erythematosus

2004 ◽  
Vol 23 (5) ◽  
pp. 416-420 ◽  
Author(s):  
Tim K. Tso ◽  
Hui-Yu Huang ◽  
Chen-Kang Chang ◽  
Ying-Ju Liao ◽  
Wen-Nan Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Clinical Evaluation ◽  
Lupus Erythematosus ◽  
Cell Function ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Systemic Lupus

Higher Prevalence and Degree of Insulin Resistance in Patients with Rheumatoid Arthritis than in Patients with Systemic Lupus Erythematosus

2020 ◽  
pp. jrheum.200435
Author(s):  
Juan C. Quevedo-Abeledo ◽  
Hiurma Sánchez-Pérez ◽  
Beatriz Tejera-Segura ◽  
Laura de Armas-Rillo ◽  
Soledad Ojeda ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Beta Cell ◽  
Lupus Erythematosus ◽  
Beta Cell Function ◽  
Cell Function ◽  
Multivariable Analysis ◽  
Model Assessment ◽  
Systemic Lupus

Objective Since insulin resistance (IR) is highly prevalent in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), we aimed to determine whether differences in IR between the two conditions exist. Methods Cross-sectional study that encompassed 413 non-diabetic subjects, 186 SLE and 227 RA. Glucose, insulin and C-peptide serum levels, as well as IR by the homeostatic model assessment (HOMA2) were studied. A multivariable regression analysis was performed to evaluate the differences in IR indexes between patients with SLE and RA, and also to determine if IR risk factors or disease-related characteristics are differentially associated with IR in both populations. Results The insulin:C-peptide molar ratio was upregulated in RA compared to SLE patients (beta coef. 0.009 [95%CI 0.005-0.014], p=0.000) after multivariable analysis. HOMA2 indexes related to insulin sensitivity were found to be lower (HOMA2-S% beta coef. -27 [95%CI -46- -9], p=0.004) and beta cell function showed higher IR indexes (HOMA2-B% beta coef. 38 [95%CI 23-52], p=0.000) in RA than in SLE patients after multivariable analysis. RA patients more often fulfilled the definition of IR than those with SLE (odds ratio 2.15 [95%CI 1.25-3.69], p=0.005). The size effect of IR factors on IR indexes was found to be equal in both diseases. Conclusion IR sensitivity is lower and beta cell function is higher in RA than in SLE patients. The fact that traditional IR factors have an equal effect on IR in both SLE and RA supports the contention that these differences are related to the diseases themselves.

Clinical significance of leptin in systemic lupus erythematosus

2021 ◽  
Vol 15 (6) ◽  
pp. 61-66
Author(s):  
L. V. Kondratyeva ◽  
T. A. Panafidina ◽  
T. V. Popkova ◽  
Yu. N. Gorbunova ◽  
M. V. Cherkasova
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Overweight And Obesity ◽  
Immunoreactive Insulin ◽  
Model Assessment ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Calculated Concentration

Objective: to study the frequency of hyperleptinemia in patients with systemic lupus erythematosus (SLE), its relationship with clinical and laboratory manifestations of the disease, drug therapy, and other metabolic disorders.Patients and methods. The cross-sectional study included 46 women with a definite diagnosis of SLE (median age 40 [31; 48] years) and disease duration 3.0 [0.9; 9.0] years. Glucocorticoids (GC) were received by 38 (83%) patients, hydroxychloroquine – by 35 (76%), immunosuppressants – by 10 (22%), biologic disease-modifying antirheumatic drugs – by 5 (11%). In all patients, fasting levels of glucose, leptin, apoliproprotein B (ApoB) and immunoreactive insulin were determined, and homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. Concentration of leptin ≥11.1 ng/ml, ApoB – >1.6 mg/ml were considered an elevated level. HOMA-IR index ≥2.77 corresponded to the presence of insulin resistance (IR).Results and discussion. Hyperleptinemia was found in 34 (74%) patients with SLE, an increased level of ApoB – in 19 (41%), IR – in 10 (22%). In patients with hyperleptinemia, serositis, positivity for anti-double-stranded DNA (aDNA) and hypocomplementemia were less common, overweight and obesity were more frequent, the SLEDAI-2K index was lower, the aDNA level was lower, and the concentration of the C3 component of complement, insulin, HOMA-IR index, body mass index (BMI) and disease duration were higher (p<0.05 for all cases). BMI <25 kg / m2 had 26 (57%) women, 14 (54%) of whom had hyperleptinemia. In patients with BMI <25 kg / m2, we found a relationship between leptin concentration and disease duration (r=0.4, p=0.04), SLE activity according to SLEDAI-2K (r=-0.6, p=0.003), levels of aDNA (r=-0.6, p<0.001), C3 component of complement (r=0.5, p=0.01), maximum (r=0.7, p<0.001) and supporting (r=0,5, p=0.023) GC doses.In patients with BMI ≥25 kg/m2 (n=20), no such relationship was observed.Conclusion. Hyperleptinemia was found in the majority of women with SLE; elevated levels of ApoB and IR were much less common. Patients with hyperleptinemia are characterized by a longer duration and less activity of the disease, as well as the presence of overweight and obesity and an increase in the HOMA-IR index. In SLE patients with normal body weight, the concentration of leptin increased along with GC dose elevation.

Insulin resistance and serum levels of adipokines in patients with systemic lupus erythematosus: a systematic review and meta-analysis

Lupus ◽  
2020 ◽  
Vol 29 (9) ◽  
pp. 1078-1084
Author(s):  
Che-Yuan Kuo ◽  
Tsung-Yu Tsai ◽  
Yu-Chen Huang
Keyword(s):  
Systematic Review ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Meta Analysis ◽  
Serum Levels ◽  
Serum Adiponectin ◽  
Model Assessment ◽  
Systemic Lupus

Background We aimed to perform a systematic review and meta-analysis of studies assessing the homeostasis model assessment for insulin resistance (HOMA-IR) values, serum adiponectin, leptin and resistin levels in patients with systemic lupus erythematosus (SLE). Method Online databases were searched on 31 March 2019 in order to identify studies comparing HOMA-IR, serum adiponectin, leptin and resistin levels between patients with SLE and controls. A random-effects model was adopted. Results Fifty-six studies involving a total of 4460 patients with SLE were included. Patients with SLE had significantly higher HOMA-IR values (standardized mean difference (SMD)=0.425; 95% confidence interval (CI) 0.156–0.693; I2=93.8%) than the control group. The serum levels of adiponectin (SMD=0.547; 95% CI 0.219–0.874; I2=90.1%), leptin (SMD=0.843; 95% CI 0.454–1.231; I2=94.4%) and resistin (SMD=0.856; 95% CI 0.199–1.513; I2=96.6%) were all higher among patients with SLE than controls. A meta-regression analysis revealed that the serum resistin level was positively correlated with disease activity (coefficient 0.123; 95% CI 0.051–0.195; p<0.001). Conclusion Patients with SLE have higher HOMA-IR values and serum levels of adiponectin, leptin and resistin than individuals without SLE. The serum level of resistin correlates with SLE disease activity.

Magnesium intake, insulin resistance and markers of endothelial function among women

2021 ◽  
pp. 1-9
Author(s):  
Narges Ghorbani Bavani ◽  
Parvane Saneei ◽  
Ammar Hassanzadeh Keshteli ◽  
Ahmadreza Yazdannik ◽  
Ebrahim Falahi ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Insulin Sensitivity ◽  
Endothelial Dysfunction ◽  
Endothelial Function ◽  
Adhesion Molecule ◽  
Cell Function ◽  
Intercellular Adhesion Molecule ◽  
Model Assessment ◽  
Serum Concentrations ◽  
Homeostasis Model Assessment

Abstract Objective: We investigated the association of dietary Mg intake with insulin resistance and markers of endothelial function among Iranian women. Design: A cross-sectional study. Setting: Usual dietary intakes were assessed using a validated FFQ. Dietary Mg intake was calculated by summing up the amount of Mg in all foods. A fasting blood sample was taken to measure serum concentrations of glycemic indices (fasting plasma glucose and insulin) and endothelial function markers (E-selectin, soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1). Insulin resistance and sensitivity were estimated using the Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), Homeostasis Model Assessment β-cell function (HOMA-β) and quantitative insulin sensitivity check index (QUICKI). Participants: Iranian female nurses (n 345) selected by a multistage cluster random sampling method. Results: The Mg intake across energy-adjusted quartiles was 205 (se 7), 221·4 (se 8), 254·3 (se 7) and 355·2 (se 9) mg/d, respectively. After adjustments for potential confounders, QUICKI level was significantly different across quartiles of Mg intake (Q1: 0·34 (se 0·02), Q2: 0·36 (se 0·01), Q3: 0·40 (se 0·01), and Q4: 0·39 (se 0·02), P = 0·02); however, this association disappeared after considering markers of endothelial function, indicating that this relation might be mediated through endothelial dysfunction. After controlling for all potential confounders, Mg intake was inversely, but not significantly, associated with serum concentrations of sICAM (Q1: 239 (se 17), Q2: 214 (se 12), Q3: 196 (se 12), and Q4: 195 (se 17), P = 0·29). There was no other significant association between dietary Mg intake and other indicators of glucose homoeostasis or endothelial markers. Conclusions: Higher dietary Mg intake was associated with better insulin sensitivity in Iranian females. This linkage was mediated through reduced endothelial dysfunction.

Beta Cell Function is Disrupted in Patients with Systemic Lupus Erythematosus

Rheumatology ◽  
2020 ◽  
Author(s):  
Alicia García-Dorta ◽  
Juan Carlos Quevedo-Abeledo ◽  
Íñigo Rua-Figueroa ◽  
Antonia M de Vera-González ◽  
Alejandra González-Delgado ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Beta Cell ◽  
Lupus Erythematosus ◽  
Cell Function ◽  
Multivariable Analysis ◽  
Serum Levels ◽  
Cell Secretion ◽  
Systemic Lupus ◽  
Proinsulin Processing ◽  
Beta Cell Secretion

Abstract Introduction To investigate how markers of beta cell secretion (proinsulin-processing metabolites) are expressed in systemic lupus erythematosus (SLE) patients and their potential relation to features associated with the disease such as activity or damage. Methods 144 SLE patients and 69 nondiabetic sex- and age-matched controls were assessed. Beta-cell secretion molecules, as measured by insulin, split and intact proinsulins, and C-peptide levels were analyzed in both groups. Multiple regression analysis was performed to compare proinsulin propeptides between groups and to explore the interrelations with SLE features. Analyses were adjusted for glucocorticoid intake and for insulin resistance classic risk factors. Results Fully multivariable analysis demonstrated that regardless of glucocorticoid use, SLE patients exhibited higher levels of split proinsulin. Likewise, the split proinsulin-to-insulin ratio was upregulated in patients with SLE undergoing glucocorticoid therapy (beta coef. 0.19 [95%CI 0.07–0.30], p= 0.002) or not (beta coef. 0.09 [95%CI 0.01–0.17), p= 0.025). Similar results were found for the intact proinsulin-to-insulin ratio, although differences were only statistically significant for patients taking glucocorticoids (beta coef. 0.08 [95%CI 0.03–0.12], p= 0.001). SLE damage score was associated with higher serum levels of intact (beta coef. 0.51 [95%CI 0.17–0.86] pmol/l, p= 0.004) and split proinsulins (beta coef. 1.65 [95%CI 0.24–3.06] pmol/l, p= 0.022) after multivariable analysis, including disease duration and prednisone use. Conclusion Among patients with SLE, proinsulin-processing metabolites, a marker of beta-cell disruption, are upregulated compared with matched controls. This disproportionate hyperproinsulinemia can be explained by the damage produced by the disease and occurs independently of prednisone use.

scholarly journals Interference of levamisole with inhibition of E-rosette formation by Hodgkin's disease and systemic lupus erythematosus cytotoxic sera

Blood ◽  
1979 ◽  
Vol 53 (5) ◽  
pp. 1002-1006 ◽  
Author(s):  
GS Del Giacco ◽  
S Tognella ◽  
AL Leone ◽  
F Locci ◽  
P Cornaglia ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cell ◽  
Lupus Erythematosus ◽  
Hodgkin's Disease ◽  
Cell Function ◽  
Human Peripheral Blood ◽  
Hodgkin’S Disease ◽  
Peripheral Blood Lymphocytes ◽  
Systemic Lupus ◽  
T Cell Function

Abstract A new system has been used to test the influence of levamisole on T- cell function. Evidence has been produced that prior exposure to the drug “protects” normal human peripheral blood lymphocytes from the inhibition that cytotoxic sera from patients with Hodgkin's disease and systemic lupus erythematosus exhibit on their E-rosette-forming capacity. Also, damage of this T-cell function already induced by Hodgkin's sera may be partially corrected.

scholarly journals Fasting triglycerides and glucose index: a useful screening test for assessing insulin resistance in patients diagnosed with rheumatoid arthritis and systemic lupus erythematosus

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Betsabe Contreras-Haro ◽  
Sandra Ofelia Hernandez-Gonzalez ◽  
Laura Gonzalez-Lopez ◽  
Maria Claudia Espinel-Bermudez ◽  
Leonel Garcia-Benavides ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Insulin Resistance ◽  
Lupus Erythematosus ◽  
Screening Test ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Factors Associated ◽  
Tyg Index ◽  
Surrogate Index

Abstract Background Insulin resistance (IR) is frequently observed in patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). In clinical practice, IR assessment is limited to a low proportion of patients due to cost and equipment and technical expertise requirements. The surrogate index of triglycerides and glucose (TyG index) has been validated in non-rheumatic populations, showing adequate sensitivity and specificity for IR, although this index has not yet been used in connective tissue disorders. The aim of this study was to evaluate the frequency of insulin resistance (IR) using the validated surrogate index of triglycerides and glucose (TyG index) and to explore factors associated with IR in Mexican women with RA or SLE. Methods Ninety-five female RA and 57 SLE patients were included in a cross-sectional study. Clinical and epidemiological variables were evaluated. IR was assessed using the TyG index with a cutoff value of > 4.68. Logistic regression analysis was performed to identify factors associated with IR excluding confounders. Results IR frequency in the entire sample was 50%, higher than the 10% observed in non-rheumatic controls (p < 0.001). The frequency of IR was similar in SLE (49.1%) and RA (50.5%, p = 0.8) patients. IR was associated with a longer duration of hypertension and higher total cholesterol and low density lipoprotein cholesterol levels. Based on multivariate analysis, the duration of hypertension (OR: 1.06; 95% CI 1.002–1.12, p = 0.04), waist circumference (OR: 1.04; 95% CI 1.01–1.08, p = 0.007), uric acid levels (OR: 1.46; 95% CI 1.08–1.97, p = 0.01), RA (OR: 4.87; 95% CI 1.31–18.78, p = 0.01) and SLE (OR: 4.22; 95% CI 1.06–16.74, p = 0.04) were the main risk factors for IR. Conclusions This study shows that the TyG index is a useful screening test for IR in RA and SLE patients. Future longitudinal studies should be performed with the aim of identifying the predictive value of TyG index results for identifying complications linked to IR.

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