Abstract
ObjectivesDespite of the European League Against Rheumatism (EULAR) provided different sets of recommendations for the management of cardiovascular risk in inflammatory arthritis patients, it must be pointed out that cardiometabolic comorbidity, such as type 2 diabetes (T2D), remains still underdiagnosed and undertreated in patients affected by rheumatoid arthritis (RA).MethodsIn this work, we designed a single centre, prospective study in order to better investigate the occurrence of T2D during the course of 1 year of follow-up. Furthermore, we evaluated the role of both traditional cardiovascular and RA-specific related risk factors to predict the occurrence of new T2D.ResultsIn this study, we evaluated 439 consecutive RA patients and we observed that 7.1% of our patients (31/439) developed T2D, after 12 month of prospective follow-up. The regression analysis showed that the presence of high blood pressure, the impaired fasting glucose (IFG) at the first observation and the poor EULAR-DAS28 response, after 12 months of follow–up, were significantly associated with an increased likelihood of being classified as T2D. Similarly, we observed that 7.7% of our patients (34/439) showed IFG after 12 months of prospective follow-up. The regression analysis showed that the presence of high blood pressure and the poor EULAR-DAS28 response after 12 months of follow-up, were significantly associated with an increased likelihood of showing IFG.ConclusionsOur study supports the hypothesis of a significant short-term risk of T2D in RA patients and of a close associations between uncontrolled disease activity and glucose metabolism derangement. Further multicentre, randomised-controlled studies are surely needed in order to elucidate these findings and to better ascertain the possible contribution of different therapeutic regimens to reduce this risk.
Highlights
Rheumatoid arthritis (RA) is a systemic, inflammatory, autoimmune disorder, mainly affecting the joints and associated with a reduction of quality of life [1]
We evaluated 439 consecutive RA patients and we observed that 7.1% of our patients (31/439) developed type 2 diabetes (T2D), after 12 month of prospective follow-up
The regression analysis showed that the presence of high blood pressure, the impaired fasting glucose (IFG) at the first observation and the poor European League Against Rheumatism (EULAR)-DAS28 response, after 12 months of follow–up, were significantly associated with an increased likelihood of being classified as T2D
Summary
Rheumatoid arthritis (RA) is a systemic, inflammatory, autoimmune disorder, mainly affecting the joints and associated with a reduction of quality of life [1]. A growing body of evidence is focused on the development of associated comorbidities and their management in rheumatic patients [6,7,8] In this context, it has been shown that a large percentage of RA patients can be affected by T2D, as reported by meta-analytic data [9,10]. It has been shown that a large percentage of RA patients can be affected by T2D, as reported by meta-analytic data [9,10] This clinical phenotype may result from a sinergy between an elevated prevalence of traditional risk factors and pro-inflammatory milieu [11,12]. Early reports suggest that biologic agents commonly used to treat RA patients may be effective in controlling comorbid T2D in both preclinical and clinical settings [13,14,15,16,17]
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