scholarly journals Cumulative inflammatory burden and obesity as determinants of insulin resistance in patients with established rheumatoid arthritis: cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044749
Author(s):  
Sara Manrique-Arija ◽  
Natalia Mena-Vazquez ◽  
Inmaculada Ureña ◽  
José Rioja ◽  
Pedro Valdivielso ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Insulin Resistance ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Model Assessment ◽  
Established Rheumatoid Arthritis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inflammatory Burden

ObjectivesTo 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.DesignObservational cross-sectional study.ParticipantsPatients with RA and controls matched for age, sex and Body Mass Index. We excluded patients with diabetes.SettingsPatients from an RA inception cohort at Hospital Regional Universitario de Málaga, Spain, were recruited between September 2016 and May 2018.Primary and secondary outcome measuresIR 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.ResultsEighty-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.ConclusionIn patients with well-controlled, established RA, IR is associated mainly with poorer control of inflammation from diagnosis and with obesity, specifically total fat mass.

Periodontitis in Italian patients with established rheumatoid arthritis: a cross‐sectional study

Oral Diseases ◽  
2021 ◽  
Author(s):  
Dimitra Karapetsa ◽  
Arianna Consensi ◽  
Giulia Castagnoli ◽  
Morena Petrini ◽  
Matteo Tonelli ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cross Sectional Study ◽  
Established Rheumatoid Arthritis ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Concordance between fasting plasma glucose and HbA1c in the diagnosis of diabetes in black South African adults: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046060
Author(s):  
Alisha N Wade ◽  
Nigel J Crowther ◽  
Shafika Abrahams-Gessel ◽  
Lisa Berkman ◽  
Jaya A George ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
South African ◽  
Plasma Glucose ◽  
Fat Distribution ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
South African Population ◽  
Cross Sectional ◽  
Black South African

ObjectivesWe investigated concordance between haemoglobin A1c (HbA1c)-defined diabetes and fasting plasma glucose (FPG)-defined diabetes in a black South African population with a high prevalence of obesity.DesignCross-sectional study.SettingRural South African population-based cohort.Participants765 black individuals aged 40–70 years and with no history of diabetes.Primary and secondary outcome measuresThe primary outcome measure was concordance between HbA1c-defined diabetes and FPG-defined diabetes. Secondary outcome measures were differences in anthropometric characteristics, fat distribution and insulin resistance (measured using Homoeostatic Model Assessment of Insulin Resistance (HOMA-IR)) between those with concordant and discordant HbA1c/FPG classifications and predictors of HbA1c variance.ResultsThe prevalence of HbA1c-defined diabetes was four times the prevalence of FPG-defined diabetes (17.5% vs 4.2%). Classification was discordant in 15.7% of participants, with 111 individuals (14.5%) having HbA1c-only diabetes (kappa 0.23; 95% CI 0.14 to 0.31). Median body mass index, waist and hip circumference, waist-to-hip ratio, subcutaneous adipose tissue and HOMA-IR in participants with HbA1c-only diabetes were similar to those in participants who were normoglycaemic by both biomarkers and significantly lower than in participants with diabetes by both biomarkers (p<0.05). HOMA-IR and fat distribution explained additional HbA1c variance beyond glucose and age only in women.ConclusionsConcordance was poor between HbA1c and FPG in diagnosis of diabetes in black South Africans, and participants with HbA1c-only diabetes phenotypically resembled normoglycaemic participants. Further work is necessary to determine which of these parameters better predicts diabetes-related morbidities in this population and whether a population-specific HbA1c threshold is necessary.

scholarly journals Insulin resistance in PLHIV on HAART and HAART naïve PLHIV: A Cross-sectional Study

2020 ◽  
pp. 1-3
Author(s):  
Prabir Kumar Ganguly ◽  
Niladri Das
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
Metabolic Effects ◽  
People Living With Hiv ◽  
Model Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Group I

ABSTRACT HAART (Highly active antiretroviral therapy) has transformed a fatal disease to a chronic, manageable disease. But long term toxicities are emerging after prolonged exposure to antiretroviral therapy(ART). Adverse metabolic effects like dyslipidemia, increased blood pressure, and insulin resistance(IR) have been attributed to HAART. Therefore, the use of HAART raises concerns regarding metabolic disorders and cardiovascular risk in HIV(Human immunodeficiency virus) infected patients. Objective: To determine the prevalence of insulin resistance in a cohort of HIV infected patients on HAART as compared to HAART naïve PLHIV(People living with HIV) Methods: A cross sectional study includes 53 subjects, out of which 26 were PLHIV on ART –Group I, 27 were ART naïve PLHIV-Group II was conducted. Insulin resistance was determined by homeostasis model assessment (HOMA-IR) mathematical model. Statistical analysis was performed to assess the association between demographic, clinical characteristics, laboratory results and insulin resistance. Results: 69.5 % PLHIV on HAART showed IR, as compared to 37 % of ART naïve PLHIV (p= 0.01). MetS(Metabolic Syndrome) was found in 53.8% among PLHIV on ART , compared to 11.1% among ART naïve PLHIV(p= 0.001) .In the multivariate analysis, presence of metabolic syndrome was found to be directly associated with insulin resistance.

scholarly journals Can neck circumference predict insulin resistance in older people? A cross-sectional study at primary care in Brazil

2017 ◽  
Vol 33 (8) ◽  
Author(s):  
Maria Auxiliadora Nogueira Saad ◽  
Maria Luiza Garcia Rosa ◽  
Giovanna Balarini Lima ◽  
Rubens Antunes da Cruz Filho
Keyword(s):  
Insulin Resistance ◽  
Primary Care ◽  
Cardiovascular Risk ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Neck Circumference ◽  
Anthropometric Measurements ◽  
Model Assessment ◽  
Sectional Study ◽  
Cross Sectional

Abstract: This study focused on the correlation between neck circumference and other anthropometric measurements and cardiovascular risk factors and insulin resistance in the elderly in Niterói, Rio de Janeiro State, Brazil. This was a cross-sectional study in 411 patients seen in primary care. Anthropometric measurements including neck circumference, body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) were recorded. Bioelectrical impedance analysis (BIA) estimated the percentage of total body fat (%TBF). Insulin resistance was estimated by HOMA-IR (homeostasis model assessment IR index). The data were analyzed by the Mann-Whitney test and the correlation between numerical variables by Spearman’s test. Receiver operating characteristic (ROC) was used to assess the anthropometric measurements’ predictive capacity to diagnosis insulin resistance. Neck circumference was positively correlated with WC, BMI, WHR, %TBF, and HOMA-IR in both sexes. In women, neck circumference showed higher AUC (area under the curve) for insulin resistance. In men, WC showed higher AUC, followed by BMI and neck circumference. The current study in Southeast Brazil suggests that neck circumference can predict insulin resistance, an important marker of cardiovascular risk in the elderly population treated in primary care.

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