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Hydroxychloroquine improves insulin sensitivity in obese non-diabetic individuals

DOI: 10.1186/ar3868

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Abstract:

We recruited 13 obese, non-diabetic subjects without systemic inflammatory conditions for an open-label longitudinal study of HCQ 6.5 mg per kilogram per day for six weeks. Subjects underwent an oral glucose tolerance test at three time points: 0 weeks (pre-treatment with HCQ), 6 weeks (at the end of the HCQ treatment), and 12 weeks (6 weeks post HCQ-treatment). The Matsuda Insulin Sensitivity Index (ISI), HOMA-IR, and HOMA-B were compared across time-points.The mean age of the cohort was 49 years, 77% females and median body mass index was 36.1 kg/m2. After 6 weeks of HCQ therapy, ISI increased from a median (interquartile range) of 4.5 (2.3-7.8) to 8.9 (3.7-11.4) with a p-value of 0.040, and HOMA-IR decreased from a median of 2.1 (1.6-5.4) to 1.8 (1.02-2.1) with a p-value of 0.09. All these variables returned toward baseline at week 12.HCQ use for 6 weeks in non diabetic obese subjects was associated with a significant increase in ISI and trends toward reduced insulin resistance and insulin secretion. These data suggest that HCQ, a common medication used to treat RA, possesses beneficial effects upon insulin sensitization. Further study of the insulin sensitizing effects of HCQ in patients with RA is warranted.Individuals with several different rheumatic diseases carry a greater risk of developing cardiovascular disease (CVD)[1-4] . It is likely that the systemic inflammation underpinning these conditions contributes to an increased risk of CVD [5]. One possible link between the systemic inflammation of rheumatic diseases and an increased risk of CVD is worsening of insulin resistance. Insulin resistance is a common risk factor for both CVD and diabetes mellitus (DM) [6]. Insulin resistance refers to impaired insulin sensitivity and glucose metabolism, and commonly precedes development of DM [6]. Additionally, insulin resistance represents one facet of the metabolic syndrome, a constellation of risk factors that predict CVD events [1,2,7,8].Insulin resistance occu

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