Patients with inflammatory arthritis have a high prevalence of insulin resistance and dyslipidemia. Although this prevalence has been explained by the acute phase response and excess weight, no complete explanation was possible for the dyslipidemia.
A known association existed between rheumatoid arthritis (RA) and an increased mortality rate from cardiovascular disease. A possible correlation had also been previously reported between the acute phase response in RA and insulin resistance, and dyslipidemia.
Consequently, clinicians from Johannesburg Hospital at the University of Witwatersrand, Johannesburg, South Africa investigated the acute phase response for insulin resistance, dyslipidemia and excess weight in patients with inflammatory diabetes.
Eighty-seven patients participated in the study: 38 had rheumatoid arthritis, 29 spondyloarthropathy, and 20 undifferentiated inflammatory arthritis. In addition, 30 healthy volunteers, who were age, gender and racially matched, served as controls.
Investigations included determination of erythrocyte sedimentation rate (ESR), plasma glucose, serum insulin, and total cholesterol, low density lipoprotein cholesterol (LPD-chol), high density lipoprotein cholesterol (HDL-chol) and triglycerides. The homeostasis model assessment for insulin resistance (HOMA) and the quantitative insulin sensitivity check index (QUICKI) was used to estimate insulin resistance.
Measurements in patients indicated the mean (SD) HOMA (µU.mmol/ml.l) QUICKI, body mass index (BMI.kg/m²), and ESR (mm/h) were 1.1 (0.5), 0.393 (0.048), 22.9 (2.8), and 13 (8). Measurements for the controls were 1.9 (1.3), 0.357 (0.037), 26.5 (4.2) and 26 (18). Each of these differences were considered highly significant (p<0.001).
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