PMID- 33771189
OWN - NLM
STAT- MEDLINE
DCOM- 20210621
LR  - 20210621
IS  - 1478-6362 (Electronic)
IS  - 1478-6354 (Print)
IS  - 1478-6354 (Linking)
VI  - 23
IP  - 1
DP  - 2021 Mar 26
TI  - Impact of disease activity on impaired glucose metabolism in patients with 
      rheumatoid arthritis.
PG  - 95
LID - 10.1186/s13075-021-02476-0 [doi]
LID - 95
AB  - OBJECTIVE: To explore glucose metabolism in rheumatoid arthritis (RA) and its 
      association with insulin resistance (IR) risk factors and disease activity 
      indicators, including matrix metalloproteinase-3 (MMP3). METHODS: This 
      single-center study included 127 non-diabetic subjects: 90 RA patients and 37 
      matched controls. IR-related risk factors, disease activity (DAS28-ESR/CRP), 
      concentrations of inflammation markers, MMP3, glucose, specific insulin, and 
      C-peptide (a marker of beta-cell secretion) were determined. Homeostasis Model 
      Assessment was used to establish insulin resistance (HOMA2-IR) and sensitivity 
      (HOMA2-%S). Associations of HOMA2 indices with IR-related risk factors, 
      inflammation markers, and RA activity were tested using multiple regression 
      analyses. RESULTS: RA patients had significantly increased HOMA2-IR index than 
      controls. In the RA group, multivariate analysis revealed DAS28-ESR, DAS28-CRP, 
      tender joint counts, patient's global assessment, and MMP3 level as significant 
      positive predictors for HOMA2-IR (beta = 0.206, P = 0.014; beta = 0.192, P = 0.009; 
      beta = 0.121, P = 0.005; beta = 0.148, P = 0.007; beta = 0.075, P = 0.025, respectively), 
      and reciprocal negative for HOMA2-%S index. According to the value of the 
      coefficient of determination (R(2)), DAS28-ESR >/= 5.1 has the largest proportion 
      of variation in both HOMA2-IR indices. DAS28-ESR >/= 5.1 and ESR were independent 
      predictors for increased C-peptide concentration (beta = 0.090, P = 0.022; 
      beta = 0.133, P = 0.022). Despite comparability regarding all IR-related risk 
      factors, patients with DAS28-ESR >/= 5.1 had higher HOMA2-IR than controls [1.7 
      (1.2-2.5) vs. 1.2 (0.8-1.4), P = 0.000]. There was no difference between patients 
      with DAS28-ESR < 5.1 and controls [1.3 (0.9-1.9) vs. 1.2 (0.8-1.4), P = 0.375]. 
      CONCLUSIONS: RA activity is an independent risk factor for impaired glucose 
      metabolism. DAS28-ESR >/= 5.1 was the main contributor to this metabolic 
      disturbance, followed by MMP3 concentration, outweighing the impact of classic 
      IR-related risk factors.
FAU - Ristic, Gorica G
AU  - Ristic GG
AUID- ORCID: 0000-0001-5760-492X
AD  - Department of Rheumatology and Clinical Immunology of the Military Medical 
      Academy and Medical Faculty of the Military Medical Academy, University of 
      Defense in Belgrade, Crnotravska 17, Belgrade, 11000, Serbia. goricaris@eunet.rs.
FAU - Subota, Vesna
AU  - Subota V
AD  - Institute of Medical Biochemistry of the Military Medical Academy and Medical 
      Faculty of the Military Medical Academy, University of Defense in Belgrade, 
      Belgrade, Serbia.
FAU - Stanisavljevic, Dejana
AU  - Stanisavljevic D
AD  - Institute of Medical Statistics, Faculty of Medicine, University of Belgrade, 
      Belgrade, Serbia.
FAU - Vojvodic, Danilo
AU  - Vojvodic D
AD  - Institute for Medical Research of the Military Medical Academy and Medical 
      Faculty of the Military Medical Academy, University of Defense in Belgrade, 
      Belgrade, Serbia.
FAU - Ristic, Arsen D
AU  - Ristic AD
AD  - Department of Cardiology of the University Clinical Centre of Serbia and Faculty 
      of Medicine, University of Belgrade, Belgrade, Serbia.
FAU - Glisic, Branislava
AU  - Glisic B
AD  - Department of Rheumatology and Clinical Immunology of the Military Medical 
      Academy and Medical Faculty of the Military Medical Academy, University of 
      Defense in Belgrade, Crnotravska 17, Belgrade, 11000, Serbia.
FAU - Petronijevic, Milan
AU  - Petronijevic M
AD  - Department of Rheumatology and Clinical Immunology of the Military Medical 
      Academy and Medical Faculty of the Military Medical Academy, University of 
      Defense in Belgrade, Crnotravska 17, Belgrade, 11000, Serbia.
FAU - Stefanovic, Dusan Z
AU  - Stefanovic DZ
AD  - Department of Rheumatology and Clinical Immunology of the Military Medical 
      Academy and Medical Faculty of the Military Medical Academy, University of 
      Defense in Belgrade, Crnotravska 17, Belgrade, 11000, Serbia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210326
PL  - England
TA  - Arthritis Res Ther
JT  - Arthritis research & therapy
JID - 101154438
RN  - 0 (Biomarkers)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - *Arthritis, Rheumatoid/diagnosis
MH  - Biomarkers
MH  - Blood Sedimentation
MH  - C-Reactive Protein/analysis
MH  - Glucose
MH  - Humans
MH  - *Insulin Resistance
MH  - Risk Factors
MH  - Severity of Illness Index
PMC - PMC7995801
OTO - NOTNLM
OT  - Insulin resistance
OT  - Matrix metalloproteinase-3
OT  - Rheumatoid arthritis
COIS- The authors declare that they have no competing interests.
EDAT- 2021/03/28 06:00
MHDA- 2021/06/22 06:00
PMCR- 2021/03/26
CRDT- 2021/03/27 05:31
PHST- 2020/11/14 00:00 [received]
PHST- 2021/03/09 00:00 [accepted]
PHST- 2021/03/27 05:31 [entrez]
PHST- 2021/03/28 06:00 [pubmed]
PHST- 2021/06/22 06:00 [medline]
PHST- 2021/03/26 00:00 [pmc-release]
AID - 10.1186/s13075-021-02476-0 [pii]
AID - 2476 [pii]
AID - 10.1186/s13075-021-02476-0 [doi]
PST - epublish
SO  - Arthritis Res Ther. 2021 Mar 26;23(1):95. doi: 10.1186/s13075-021-02476-0.