Background Insulin resistance (IR) is a comorbidity found in about 40%of RA patients. Currently, there is little information regarding the role of antibodies against citrullinated proteins and IR development in RA. Patients positive for ACPA and/or RF may be at higher risk of IR since these group of patients has a higher expression pro-inflammatory citokines like TNFa and IL-6, both implicated in the pathogenesis of IR.
Objectives To analyze the contribution of autoantibodies positivity (ACPA and/or RF) and their impact in the development of IR in patients with RA.
Methods We retrospectively analyzed patients classified with RA per ACR 1987 and ACR/EULAR 2010 criteria with at least one year of follow-up in a cohort of RA patients without comorbidities from Hospital Civil “Juan I. Menchaca”. DAS-28, basal insulin, HOMA-IR and anthropometric parameters: Body weight, body mass index (BMI), Sum 4 skinfold thicknesses (S4T), Waist to hip ratio (WHR), waist circumference (WC) and total fat mass (FM); were determined at current and baseline. Mean differences between the two time points were calculated. A multiple regression model was constructed considering mean insulin change as dependent variable.
Results We studied 57 RA patients, 44% (25) with IR and 56% (32) without IR. Of these, 21% (12) developed IR during follow-up. BMI, FM and ST4 were higher at baseline in patients with current IR at baseline. Ptients who developed IR during follow-up had a mean increase of DAS-28 of 1.27 (P<0.005 vs. patients who improved or never developed IR). Patients positive for ACPA had a greater increase in IR during follow-up. Multivariate analysis revealed that ACPA, increments in WHR and ST4 were independent predictors of basal insulin increases during follow-up.
Conclusions ACPA and abdominal adiposity (WHR) are independent predictors of IR development in RA
Disclosure of Interest None declared