A obesidade é um determinante da resistência à insulina mais importante do que os níveis circulantes de citocinas pró‐inflamatórias em pacientes com artrite reumatoide

Jesus Castillo‐Hernandez , Martha Imelda Maldonado‐Cervantes , Juan Pablo Reyes , Nuria Patiño‐Marin , Enrique Maldonado‐Cervantes , Claudia Solorzano‐Rodriguez , Esperanza de la Cruz Mendoza , Brenda Alvarado‐Sanchez
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引用次数: 4

Abstract

Background

Systemic blockade of TNF‐α in Rheumatoid arthritis (RA) with insulin resistance (IR) seems to produce more improvement in insulin sensitivity in normal weight patients with RA than in obese patients with RA, suggesting that systemic‐inflammation and obesity are independent risk factors for IR in RA patients.

Objectives

To evaluate the insulin resistance in: normal weight patients with RA (RA NW), overweight patients with RA (RA OW), obese RA patients (RA OB), and matched control subjects with normal weight (NW) and obesity (OB); and its association with major cytokines involved in the pathogenesis of the disease.

Methods

Assessments included: body mass index (BMI), insulin resistance by HOMA‐IR, ELISA method, and enzymatic colorimetric assay.

Results

Outstanding results from these studies include: (1) In RA patients, IR was well correlated with Body Mass Index (the higher the BMI, the higher IR), but not with levels of serum cytokines. In fact, levels of cytokines were similar in all RA patients, regardless of being obese, overweight or normal weight (2) IR was significantly higher in RA NW than in NW (3) No significant difference was observed between IRs of RA OB and OB (4) As expected, levels of circulating cytokines were significantly higher in RA patients than in OB.

Conclusions

Obesity appears to be a dominant condition above inflammation to produce IR in RA patients. The dissociation of the inflammation and obesity components to produce IR suggests the need of an independent therapeutic strategy in obese patients with RA.

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在类风湿性关节炎患者中,肥胖是胰岛素抵抗的重要决定因素,而不是循环水平的促炎细胞因子
背景:在类风湿性关节炎(RA)合并胰岛素抵抗(IR)患者中,全身阻断TNF - α似乎比肥胖RA患者胰岛素敏感性改善更多,这表明全身炎症和肥胖是RA患者IR的独立危险因素。目的评价正常体重RA患者(RA NW)、超重RA患者(RA OW)、肥胖RA患者(RA OB)以及正常体重(NW)和肥胖(OB)对照者的胰岛素抵抗情况;以及它与主要细胞因子在疾病发病机制中的关联。方法评估包括:体重指数(BMI)、胰岛素抵抗(HOMA‐IR)、ELISA法和酶促比色法。结果这些研究的突出结果包括:(1)在RA患者中,IR与身体质量指数(BMI越高,IR越高)密切相关,但与血清细胞因子水平无关。事实上,无论肥胖、超重或体重正常,所有RA患者的细胞因子水平都是相似的(2)RA NW的IR明显高于NW (3) RA OB和OB的IR之间没有显著差异(4)正如预期的那样,RA患者的循环细胞因子水平明显高于OB。结论肥胖似乎是RA患者炎症以上产生IR的主要条件。炎症和肥胖成分分离产生IR提示肥胖类风湿性关节炎患者需要一个独立的治疗策略。
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来源期刊
CiteScore
0.82
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: RBR nasceu da necessidade de se criar um órgão oficial da SBR que pudesse divulgar a produção científica dos reumatologistas brasileiros. O primeiro número foi publicado em setembro de 1957. A partir do volume 18 (1978), passou a seis números, com periodicidade atual. A RBR, em sua trajetória, tem sido objeto de constantes mudanças, sempre visando ao seu aprimoramento e revitalização, tanto em sua apresentação como em seu conteúdo.
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