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

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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Prevalence of Hyposalivation in Patients with Systemic Lupus Erythematosus in a Brazilian Subpopulation

International Journal of Rheumatology ◽

10.1155/2015/730285 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Cristhiane Almeida Leite ◽

Marcial Francis Galera ◽

Mariano Martínez Espinosa ◽

Paulo Ricardo Teles de Lima ◽

Vander Fernandes ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Salivary Flow ◽

Cross Sectional Study ◽

Systemic Lupus ◽

Cross Sectional ◽

Mato Grosso ◽

Significance Level ◽

Factors Associated ◽

Study Population

Background.Systemic lupus erythematosus (SLE) is a chronic inflammatory, multisystem, and autoimmune disease.Objective.The aim of this study was to describe the prevalence of hyposalivation in SLE patients and evaluate factors associated.Methods.This is a cross-sectional study developed at the Cuiaba University General Hospital (UNIC-HGU), Mato Grosso, Brazil. The study population consisted of female SLE patients treated at this hospital from 06/2010 to 12/2012. Unstimulated salivary flow rates (SFRs) were measured. Descriptive and inferential analyses were performed in all cases using a significance levelP<0.05.Results.The results showed that 79% of patients with systemic lupus erythematosus suffered from hyposalivation and that the disease activity and age in years were the factors that resulted in statistically significant differences.Conclusion.The activity of the disease, age >27 years, and the drugs used were factors associated with hyposalivation, resulting in a statistically significant decrease in saliva production.

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A comparative study on clinical and serological characteristics between patients with rhupus and those with systemic lupus erythematosus and rheumatoid arthritis

Lupus ◽

10.1177/0961203320938456 ◽

2020 ◽

Vol 29 (10) ◽

pp. 1216-1226

Author(s):

Beatriz Frade-Sosa ◽

Javier Narváez ◽

Tarek Carlos Salman-Monte ◽

Raul Castellanos-Moreira ◽

Vera Ortiz-Santamaria ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Disease Duration ◽

Renal Involvement ◽

Clinical Manifestations ◽

Classification Criteria ◽

Systemic Lupus ◽

Cross Sectional

Background The concomitant presence of two autoimmune diseases – systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) – in the same patient is known as rhupus. We evaluated a group of patients with rhupus to clarify further their clinical, serological and immunogenic features in a multi-centre cohort. In addition, the study aimed to explore the utility of the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in our group of patients with rhupus. Methods This was a cross-sectional study. We included rhupus patients from 11 different rheumatology departments, and compared them to SLE and RA patients at a ratio of 2:1. All information was recorded following a pre-established protocol. Results A total of 200 patients were included: 40 rhupus patients and 80 each of SLE and RA patients as controls. Disease duration was similar among SLE and rhupus groups (around 13 years), but the RA group had a significantly lower disease duration. Main clinical manifestations were articular (94.2%), cutaneous (77.5%) and haematological (72.5%). Rhupus patients had articular manifestations similar to those expected in RA. Only 10% of rhupus patients had renal involvement compared with 25% of those with SLE ( p < 0.05), while interstitial lung disease was more common in patients affected by RA. The 2019 EULAR/ACR SLE criteria were met in 92.5% of the rhupus patients and in 96.3% of the SLE cohort ( p > 0.05). Excluding the joint domain, there were no differences between the numbers of patients who met the classification criteria. Conclusion Rhupus patients follow a particular clinical course, with full expression of both SLE and RA in terms of organ involvement, except for a lower prevalence of kidney affection. The new 2019 EULAR/ACR SLE criteria are not useful for differentiating SLE and rhupus patients. A new way of classifying autoimmune diseases is needed to identify overlapping clusters.

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Factors associated with pericardial effusion in pediatric systemic lupus erythematosus

Paediatrica Indonesiana ◽

10.14238/pi58.5.2018.227-32 ◽

2018 ◽

Vol 58 (5) ◽

pp. 227-32

Author(s):

Pediana Rachmawati ◽

Indah K. Murni ◽

Sasmito Nugroho ◽

Noormanto Noormanto ◽

Sumadiono Sumadiono

Keyword(s):

Systemic Lupus Erythematosus ◽

Pericardial Effusion ◽

Hemolytic Anemia ◽

Lupus Erythematosus ◽

Medical Records ◽

Multivariate Logistic Regression Analysis ◽

Systemic Lupus ◽

Cross Sectional ◽

Pediatric Systemic Lupus Erythematosus ◽

Factors Associated

Background Cardiovascular involvement in systemic lupus erythematosus (SLE) has been reported to range from 4-78%. Complications can affect all structures of the heart, including the endocardium, myocardium, pericardium, and valves. Pericarditis is the most common manifestation, with an incidence of 11-54% in SLE patients. Pericardial effusion is often observed in patients with pericarditis, and can be confirmed by echocardiography. Objective To determine factors associated with pericardial effusion in children with SLE. Methods We conducted a restrospective cross-sectional study by reviewing medical records of children with SLE aged less than 18 years who underwent echocardiography at the Dr. Sardjito Hospital. Yogyakarta, from January 2011 to March 2018. Patients with congenital heart disease or incomplete medical records were excluded. A multivariate logistic regression analysis was done to determine factors that independetly associated with pericardial effusion. Results Among 165 children with SLE, 73 fulfilled the inclusion criteria. The prevalence of pericardial effusion was 54.8%. Median age was 13 (range 5-17) years and the female-to-male ratio was 8:1. Hemolytic anemia (OR=4.135; 95%CI 1.039 to 16.453; P=0.044) was significantly associated with pericardial effusion. Conclusion Hemolytic anemia is significantly associated with pericardial effusion in children with SLE.

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Spondyloarthropathies in Autoimmune Diseases and Vice Versa

Autoimmune Diseases ◽

10.1155/2012/736384 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Oscar M. Pérez-Fernández ◽

Rubén D. Mantilla ◽

Paola Cruz-Tapias ◽

Alberto Rodriguez-Rodriguez ◽

Adriana Rojas-Villarraga ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Autoimmune Diseases ◽

Lupus Erythematosus ◽

Clinical Characteristics ◽

Cross Sectional Study ◽

Sectional Study ◽

Systemic Lupus ◽

Two Phase ◽

Cross Sectional

Polyautoimmunity is one of the major clinical characteristics of autoimmune diseases (ADs). The aim of this study was to investigate the prevalence of ADs in spondyloarthropathies (SpAs) and vice versa. This was a two-phase cross-sectional study. First, we examined the presence of ADs in a cohort of patients with SpAs (N=148). Second, we searched for the presence of SpAs in a well-defined group of patients with ADs (N=1077) including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren’s syndrome (SS). Among patients with SpAs, ankylosing spondylitis was observed in the majority of them (55.6%). There were two patients presenting with SS in the SpA group (1.4%) and 5 patients with autoimmune thyroiditis (3.5%). The global prevalence of ADs in SpAs was 4.86%. In the ADs group, there were 5 patients with SpAs (0.46%). Our results suggest a lack of association between SpAs and ADs. Accordingly, SpAs might correspond more to autoinflammatory diseases rather than to ADs.

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Comparing the prevalence of metabolic syndrome in systemic lupus erythematosus, rheumatoid arthritis and psoriatic arthritis: A cross sectional study

Rheumatology Research ◽

10.22631/rr.2018.69997.1044 ◽

2018 ◽

Vol 3 (2) ◽

pp. 69-75

Author(s):

Maryam Mobini ◽

Fatemeh Niksolat ◽

Reza Ali Mohammadpour ◽

Sarah Sadr ◽

Saeed Dashti dargahloo

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Metabolic Syndrome ◽

Psoriatic Arthritis ◽

Lupus Erythematosus ◽

Cross Sectional Study ◽

Sectional Study ◽

Systemic Lupus ◽

Cross Sectional

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Clinical significance of leptin in systemic lupus erythematosus

Modern Rheumatology Journal ◽

10.14412/1996-7012-2021-6-61-66 ◽

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.

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Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: a cross-sectional study of the LuLa-cohort

Lupus Science & Medicine ◽

10.1136/lupus-2015-000113 ◽

2015 ◽

Vol 2 (1) ◽

pp. e000113-e000113 ◽

Cited By ~ 8

Author(s):

J. Fischin ◽

G. Chehab ◽

J. G. Richter ◽

R. Fischer-Betz ◽

B. Winkler-Rohlfing ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Cross Sectional Study ◽

Pain Coping ◽

Sectional Study ◽

Systemic Lupus ◽

Cross Sectional ◽

Factors Associated

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Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Postarthroplasty Mortality: A Cross-sectional Analysis from the Nationwide Inpatient Sample

The Journal of Rheumatology ◽

10.3899/jrheum.091371 ◽

2010 ◽

Vol 37 (7) ◽

pp. 1467-1472 ◽

Cited By ~ 25

Author(s):

ROBYN T. DOMSIC ◽

BHARATHI LINGALA ◽

ESWAR KRISHNAN

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Mortality Risk ◽

Lupus Erythematosus ◽

Nationwide Inpatient Sample ◽

Postoperative Mortality ◽

Systemic Lupus ◽

Cross Sectional ◽

Adjusted Risk ◽

Before And After

Objective.Systemic lupus erythematosus (SLE) is a disease of considerable morbidity, and this may place patients at greater risk for poor in-hospital postoperative outcomes for procedures such as arthroplasty. Our aim was to test this hypothesis.Methods.We compared the in-hospital postoperative mortality risk for patients with SLE undergoing hip and knee arthroplasty to those with rheumatoid arthritis (RA) and the general population without either condition, using data from the Nationwide Inpatient Sample (1993–2006). We performed parallel, weighted, multivariable logistic regressions to calculate mortality risk stratified by joint site, type of admission, hospital type, income category, race, length of stay, surgical indication, and medical comorbidities.Results.The unadjusted mortality rates (per 1000 procedures) for patients with SLE, patients with RA, and controls were 7.4, 3.0, and 6.5, respectively, for nonelective procedures and 2.4, 1.3, and 1.8 for elective procedures. After adjustment for potential confounders, patients with SLE had an OR of 4.0 (95% CI 1.9–8.0) for postoperative mortality with hip replacements and an OR of 1.2 (95% CI 0.2–7.5) for mortality with knee replacements. Mortality risk of patients with RA was not different from that of controls. The adjusted risk estimates for those who underwent arthroplasty before and after 2002 and those who underwent surgery for nonfracture indications were similar.Conclusion.Arthroplasty, especially of hips, in patients with SLE is associated with relatively higher postoperative mortality risk.

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Factors associated with the use of complementary therapies in Taiwanese patients with systemic lupus erythematosus: a cross-sectional study

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-021-03416-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ming-Chi Lu ◽

Hui-Chin Lo ◽

Hsiu-Hua Chang ◽

Chia-Wen Hsu ◽

Malcolm Koo

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Complementary Therapies ◽

Complementary Therapy ◽

Cross Sectional Study ◽

Sectional Study ◽

Systemic Lupus ◽

Cross Sectional ◽

Factors Associated

Abstract Background This study aimed to investigate the prevalence of and the factors associated with the regular use of complementary therapies for Taiwanese patients with systemic lupus erythematosus (SLE). Methods In this cross-sectional study, 351 patients with SLE were consecutively recruited from a regional hospital in southern Taiwan from April to August 2019. Demographic and clinical information, including the use of different types of complementary therapies, was ascertained using a self-constructed questionnaire. Disease-specific quality of life was measured using the Lupus Quality of Life (LupusQoL) questionnaire. SLE disease activity was assessed using the rheumatologist-scored Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Factors associated with the regular use of complementary therapies were evaluated using multiple logistic regression analyses. Results Of the 351 patients with SLE, 90.3% were female, and 60.1% were ≥ 40 years of age. The prevalence of the regular use of any type of complementary therapy was 85.5%. The five most popular types of complementary therapy used were (1) fitness walking or strolling, (2) Buddhist prayer or attending temple, (3) vitamin consumption, (4) calcium supplementation, and (5) fish oil supplementation. Multiple logistic regression analyses revealed that the significant and independent factors associated with the regular use of complementary therapies in patients with SLE were age ≥ 40 years (adjusted odds ratio [aOR] 2.76, p = 0.013), nonoverweight or nonobesity (aOR 0.29, p = 0.004), engagement in vigorous exercise in the past year (aOR 4.62, p = 0.002), a lower SLEDAI-2 K score (aOR 0.90, p = 0.029), and a lower score in the physical health domain of the LupusQoL (aOR 0.57, p = 0.001). Conclusions A high prevalence of complementary therapy use in Taiwanese patients with SLE was observed. Rheumatologists should routinely ask patients about their use of supplements to minimize the risk of interaction with medical therapy.

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