Clinical and Experimental Rheumatology | |
Anti-tumor necrosis factor-α blockade improves insulin resistance in patients with rheumatoid arthritis | |
J. Martin1  J.M. De Matias1  C. Gonzalez-Juanatey1  J. Llorca1  C. Garcia-Porrua1  M.A. Gonzalez-Gay1  A. Sanchez-Andrade1  | |
关键词: Rheumatoid arthritis; atherosclerosis; inflammation; anti-TNF-α antibody-infliximab; insulin resistance; insulin sensitivity; | |
DOI : | |
学科分类:医学(综合) | |
来源: Pacini Editore SpA | |
【 摘 要 】
OBJECTIVES: Systemic inflammation, insulin resistance, and endothelial dysfunction have been implicated in the development of cardiovascular disease in rheumatoid arthritis (RA). Since insulin resistance can promote endothelial dysfunction and anti-TNF-α blockade yield a rapid improvement of endothelial function, we have sought to assess whether TNF-α blockade may also result in a reduction of insulin serum levels and improvement of insulin resistance in RA patients who require this therapy because of severe and refractory disease. METHODS: We recruited patients with RA seen over a period of 1 month at Hospital Xeral-Calde, Lugo, Spain, that were on treatment with anti-TNF-α monoclonal antibody-infliximab. Patients with diabetes mellitus or plasma glucose > 110 mg/dl were excluded. Fasting blood samples were taken for determination of plasma glucose and serum insulin levels immediately prior to and after infliximab infusion. RESULTS: Twenty-seven RA patients (21 women; mean age: 57.1 years; mean DAS28: 4.43) fulfilled the inclusion criteria. Dramatic reduction in the serum insulin levels and insulin/glucose index was observed following infliximab infusion. Also, a significant improvement of insulin resistance and insulin sensitivity was found. CONCLUSIONS: Our study confirms a rapid beneficial effect of infliximab on insulin resistance and insulin sensitivity in RA patients treated periodically with this drug. It may support the long-term use of drugs that act blocking TNF-α function to reduce the mechanisms implicated in the development of atherosclerosis in patients with RA.
【 授权许可】
Unknown
【 预 览 】
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RO201912020415896ZK.pdf | 446KB | download |