%0 Journal Article
%T Effect of Anti-TNF Therapy on Resistance to Insulin in Patients with Rheumatoid Arthritis
%A Mario P¨¦rez
%A Raul Ariza
%A Ruben Asencio
%A Adolfo Camargo
%A Heladia Garcia
%A Miguel Angel Vazquez
%A Leonor Barile-Fabris
%J Open Journal of Rheumatology and Autoimmune Diseases
%P 167-171
%@ 2164-005X
%D 2013
%I Scientific Research Publishing
%R 10.4236/ojra.2013.33026
%X <b><span>Objective</span></b><b><span>:</span></b><span> </span><span>To evaluate the effect of anti-TNF therapy on resistance to insulin in patients with rheumatoid arthritis (RA) compared with patients with RA being treated with non-biological DMARDs.</span><span> </span><b><span>Methods</span></b><b><span>:</span></b><i><span> </span></i><span>Inactive patients diagnosed with RA (ACR 1987 criteria) (DAS 28</span><span> </span><span>&lt;</span><span> </span><span>2.6) were included, being treated with anti-tumor necrosis factor inhibitors (anti-TNF) (cases) and non-biological disease-modifying anti-rheumatic drugs (DMARD) (controls), without risk fac</span><span>tors for insulin resistance (administration of steroids, body mass index &gt;</span><span> </span><span>25</span><span> </span><span>kg</span><span>/m<sup>2</sup>, diabetes mellitus or use of glucose lowering agents, systemic arterial hypertension or use of anti-hypertensive drugs, triglycerides &gt;</span><span> </span><span>150</span><span> </span><span>mg/dl, hypercho</span><span>lesterolemia &gt;</span><span> </span><span>200</span><span> </span><span>mg/dl, high-density lipoproteins &lt;</span><span> </span><span>40</span><span> </span><span>mg/dl in men and &lt;</span><span> </span><span>50</span><span> </span><span>mg/in women, or with lipids lowering agents, waist measurement &gt;</span><span> </span><span>88</span><span> </span><span>cm</span><span> in women and &gt;</span><span> </span><span>102</span><span> </span><span>cm</span><span> in men). We used HOMA (Homeostasis Model Assess</span><span>ment) to determine insulin resistance in both groups, HOMA being defined as &gt;1 and sensitivity to insulin using QUICKI (Insulin Sensitivity Check Index), ¡Ý0.38 being considered as normal. The Mann Whitney U was used for the statistical analysis.</span><span> </span><b><span>Results</span></b><b><span>:</span><i><span> </span></i></b><span>A total of 28 patients, 15 being treated with non-biological DMARDs and 13 with anti-</span><span>TNF therapy, were evaluated; 89.7%, of which were women. Average age: 43.5 (range 21</span><span> </span><span>-</span><span> </span><span>62); the average HOMA index of the non-biological DMARD group was 1.58 (range 0.7</span><span> </span><span>-</span><span> </span><span>5.4), compared with patients treated with anti-TNF therapy, 1.18 (range 0.2</span><span> </span><span>-</span><span> </span><span>4.3) (P</span><span> </span><span>=</span><span> </span><span>0.5). The average QUICKI index was 0.36 (range 0.30</span><span> </span><span>-</span><span>
%K Anti-TNF
%K Resistance to Insulin
%K Rheumatoid Arthritis
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=35928