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Diabetes-Modifying Antirheumatic Drugs: The Roles of DMARDs as Glucose-Lowering Agents. Medicina (B Aires) 2022; 58:medicina58050571. [PMID: 35629988 PMCID: PMC9143119 DOI: 10.3390/medicina58050571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 02/06/2023] Open
Abstract
Systemic inflammation represents a shared pathophysiological mechanism which underlies the frequent clinical associations among chronic inflammatory rheumatic diseases (CIRDs), insulin resistance, type 2 diabetes (T2D), and chronic diabetes complications, including cardiovascular disease. Therefore, targeted anti-inflammatory therapies are attractive and highly desirable interventions to concomitantly reduce rheumatic disease activity and to improve glucose control in patients with CIRDs and comorbid T2D. Therapeutic approaches targeting inflammation may also play a role in the prevention of prediabetes and diabetes in patients with CIRDs, particularly in those with traditional risk factors and/or on high-dose corticosteroid therapy. Recently, several studies have shown that different disease-modifying antirheumatic drugs (DMARDs) used for the treatment of CIRDs exert antihyperglycemic properties by virtue of their anti-inflammatory, insulin-sensitizing, and/or insulinotropic effects. In this view, DMARDs are promising drug candidates that may potentially reduce rheumatic disease activity, ameliorate glucose control, and at the same time, prevent the development of diabetes-associated cardiovascular complications and metabolic dysfunctions. In light of their substantial antidiabetic actions, some DMARDs (such as hydroxychloroquine and anakinra) could be alternatively termed “diabetes-modifying antirheumatic drugs”, since they may be repurposed for co-treatment of rheumatic diseases and comorbid T2D. However, there is a need for future randomized controlled trials to confirm the beneficial metabolic and cardiovascular effects as well as the safety profile of distinct DMARDs in the long term. This narrative review aims to discuss the current knowledge about the mechanisms behind the antihyperglycemic properties exerted by a variety of DMARDs (including synthetic and biologic DMARDs) and the potential use of these agents as antidiabetic medications in clinical settings.
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Cayli S, Alimogullari E, Piskin I, Bilginoglu A, Nakkas H. Effect of pioglitazone on the expression of ubiquitin proteasome system and autophagic proteins in rat pancreas with metabolic syndrome. J Mol Histol 2021; 52:929-942. [PMID: 34410563 DOI: 10.1007/s10735-021-10013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 08/10/2021] [Indexed: 11/28/2022]
Abstract
The metabolic syndrome (MetS) and pathologies associated with metabolic dysregulations a worldwide growing problem. Our previous study demonstrated that pioglitazone (PGZ) has beneficial effects on metabolic syndrome associated disturbances in the heart. However, mechanism mediating the molecular alterations of Ubiquitin proteasome system (UPS) and autophagy has not been investigated in rat pancreas with metabolic syndrome. For this reason, we first aimed to detect whether MetS effects on the expression of UPS (p97/VCP, SVIP, Ubiquitin) and autophagic (p62, LC3) proteins in rat pancreas. The second aim of the study was to find impact of pioglitazone on the expression of UPS and autophagic proteins in MetS rat pancreas. To answer these questions, metabolic syndrome induced rats were used as a model and treated with pioglitazone for 2 weeks. Pancreatic tissue injuries, fibrosis and lipid accumulation were evaluated histopathologically in control, MetS and MetS-PGZ groups. Apoptosis and cell proliferation of pancreatic islet cells were assessed in all groups. UPS and autophagic protein expressions of pancreas in all groups were detected by using immunohistochemistry, double-immunfluorescence and Western blotting. Compared with the controls, the rat fed with high sucrose exhibited signs of metabolic syndrome, such as higher body weight, insulin resistance, higher triglyceride level and hyperglycaemia. MetS rats showed pancreatic tissue degeneration, fibrosis and lipid accumulation when their pancreas were examined with Hematoxilen-eozin and Mallory trichrome staining. Metabolic, histopathologic parameters and cell proliferation showed greater improvement in MetS-PGZ rats and pioglitazone decreased apoptosis of islet cells. Moreover, SVIP, ubiquitin, LC3 and p62 expressions were significantly increased while only p97/VCP expression was significantly decreased in MetS-rat pancreas compared to control. PGZ treatment significantly decreased the MetS-induced increases in autophagy markers. Additionally, UPS and autophagy markers were found to colocalizated with insulin and glucagon. Colocalization ratio of UPS markers with insulin showed significant decrease in MetS rats and PGZ increased this ratio, whereas LC3-insulin colocalization displayed significant increase in MetS rats and PGZ reversed this effect. In conclusion, PGZ improved the pancreatic tissue degeneration by increasing the level of p97/VCP and decreasing autophagic proteins, SVIP and ubiquitin expressions in MetS-rats. Moreover, PGZ has an effect on the colocalization ratio of UPS and autophagy markers with insulin.
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Affiliation(s)
- Sevil Cayli
- Department of Histology and Embryology, Medical Faculty, Ankara Yıldırım Beyazıt University, 06800, Ankara, Turkey.
| | - Ebru Alimogullari
- Department of Histology and Embryology, Medical Faculty, Ankara Yıldırım Beyazıt University, 06800, Ankara, Turkey
| | - Ilkay Piskin
- Department of Histology and Embryology, Medical Faculty, Ankara Yıldırım Beyazıt University, 06800, Ankara, Turkey
| | - Ayca Bilginoglu
- Department of Biophysics, Medical Faculty, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Hilal Nakkas
- Department of Histology and Embryology, Medical Faculty, Ankara Yıldırım Beyazıt University, 06800, Ankara, Turkey
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Kong CY, Wang CL, Niu KJ, Qi W. Prevalence of metabolic syndrome in patients with rheumatoid arthritis in eastern China-A hospital based study. Int J Rheum Dis 2021; 24:1121-1126. [PMID: 34080783 DOI: 10.1111/1756-185x.14148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this hospital clinic based study was to evaluate the potential risk factors associated with the prevalence of MetS in RA population. METHODS From January 2015 to October 2018, 717 patients with RA and 717 healthy controls who were treated or performed physical examination in Tianjin First Central Hospital were enrolled in this study. The basic disease diagnoses were recorded. A questionnaire was performed on all participants to assess the demographic details of the RA cohort. Moreover, laboratory indicators related to glucose and lipid metabolism in patients with RA were also detected. The potential risk factors for MetS were also analyzed. RESULTS The prevalence of MetS were 31.2% and 34.2% in case and control groups, respectively (P = .22). There were lower levels of HDL-C, obesity, TG, LDL-C and TC in case group than control group (all P < .05). The hypertension levels in healthy controls was decreased in compared with patients with RA (P < .05). Nevertheless, in patients with RA, complement 3 (OR: 1.02; 95% CI: 1.01-1.03, P = .007) and less glucocorticoids use (OR: 0.63, 95% CI: 0.39-0.99, P = .046) were associated with MetS. CONCLUSION The prevalence of MetS was not associated with RA. Complement 3 may be associated with the higher prevalence of MetS in patients with RA. Glucocorticoids treatment may be associated with MetS.
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Affiliation(s)
| | - Chang-Lei Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Kai-Jun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.,Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Wufang Qi
- Tianjin First Center Hospital, Tianjin, China
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Pablos JL, Galindo M, Carmona L, Lledó A, Retuerto M, Blanco R, Gonzalez-Gay MA, Martinez-Lopez D, Castrejón I, Alvaro-Gracia JM, Fernández Fernández D, Mera-Varela A, Manrique-Arija S, Mena Vázquez N, Fernandez-Nebro A. Clinical outcomes of hospitalised patients with COVID-19 and chronic inflammatory and autoimmune rheumatic diseases: a multicentric matched cohort study. Ann Rheum Dis 2020; 79:1544-1549. [PMID: 32796045 PMCID: PMC7430185 DOI: 10.1136/annrheumdis-2020-218296] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/31/2020] [Accepted: 07/31/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The impact of inflammatory rheumatic diseases on COVID-19 severity is poorly known. Here, we compare the outcomes of a cohort of patients with rheumatic diseases with a matched control cohort to identify potential risk factors for severe illness. METHODS In this comparative cohort study, we identified hospital PCR+COVID-19 rheumatic patients with chronic inflammatory arthritis (IA) or connective tissue diseases (CTDs). Non-rheumatic controls were randomly sampled 1:1 and matched by age, sex and PCR date. The main outcome was severe COVID-19, defined as death, invasive ventilation, intensive care unit admission or serious complications. We assessed the association between the outcome and the potential prognostic variables, adjusted by COVID-19 treatment, using logistic regression. RESULTS The cohorts were composed of 456 rheumatic and non-rheumatic patients, in equal numbers. Mean age was 63 (IQR 53-78) years and male sex 41% in both cohorts. Rheumatic diseases were IA (60%) and CTD (40%). Most patients (74%) had been hospitalised, and the risk of severe COVID-19 was 31.6% in the rheumatic and 28.1% in the non-rheumatic cohort. Ageing, male sex and previous comorbidity (obesity, diabetes, hypertension, cardiovascular or lung disease) increased the risk in the rheumatic cohort by bivariate analysis. In logistic regression analysis, independent factors associated with severe COVID-19 were increased age (OR 4.83; 95% CI 2.78 to 8.36), male sex (1.93; CI 1.21 to 3.07) and having a CTD (OR 1.82; CI 1.00 to 3.30). CONCLUSION In hospitalised patients with chronic inflammatory rheumatic diseases, having a CTD but not IA nor previous immunosuppressive therapies was associated with severe COVID-19.
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MESH Headings
- Adenosine Monophosphate/analogs & derivatives
- Adenosine Monophosphate/therapeutic use
- Age Factors
- Aged
- Alanine/analogs & derivatives
- Alanine/therapeutic use
- Antiviral Agents/therapeutic use
- Arthritis, Psoriatic/complications
- Arthritis, Psoriatic/drug therapy
- Arthritis, Psoriatic/epidemiology
- Arthritis, Rheumatoid/complications
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/epidemiology
- Betacoronavirus
- COVID-19
- Cardiovascular Diseases/epidemiology
- Case-Control Studies
- Cohort Studies
- Comorbidity
- Connective Tissue Diseases/complications
- Connective Tissue Diseases/drug therapy
- Connective Tissue Diseases/epidemiology
- Coronavirus Infections/complications
- Coronavirus Infections/drug therapy
- Coronavirus Infections/epidemiology
- Drug Combinations
- Female
- Glucocorticoids/therapeutic use
- Hospitalization
- Humans
- Hydroxychloroquine/therapeutic use
- Immunosuppressive Agents/therapeutic use
- Logistic Models
- Lopinavir/therapeutic use
- Lupus Erythematosus, Systemic/complications
- Lupus Erythematosus, Systemic/drug therapy
- Lupus Erythematosus, Systemic/epidemiology
- Male
- Middle Aged
- Obesity/epidemiology
- Pandemics
- Pneumonia, Viral/complications
- Pneumonia, Viral/drug therapy
- Pneumonia, Viral/epidemiology
- Polymyalgia Rheumatica/complications
- Polymyalgia Rheumatica/drug therapy
- Polymyalgia Rheumatica/epidemiology
- Prognosis
- Rheumatic Diseases/complications
- Rheumatic Diseases/drug therapy
- Rheumatic Diseases/epidemiology
- Risk Factors
- Ritonavir/therapeutic use
- SARS-CoV-2
- Severity of Illness Index
- Sex Factors
- Sjogren's Syndrome/complications
- Sjogren's Syndrome/drug therapy
- Sjogren's Syndrome/epidemiology
- Spondylarthropathies/complications
- Spondylarthropathies/drug therapy
- Spondylarthropathies/epidemiology
- COVID-19 Drug Treatment
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Affiliation(s)
- Jose L Pablos
- Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
- Universidad Complutense de Madrid, Madrid, Spain
| | - María Galindo
- Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética (INMUSC), Madrid, Spain
| | - Ana Lledó
- Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - Miriam Retuerto
- Servicio de Reumatología, Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
| | - Ricardo Blanco
- Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Miguel A Gonzalez-Gay
- Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - David Martinez-Lopez
- Servicio de Reumatología, Hospital Universitario Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - Isabel Castrejón
- Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - José M Alvaro-Gracia
- Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - David Fernández Fernández
- Servicio de Reumatología, Hospital Clínico Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Antonio Mera-Varela
- Servicio de Reumatología, Hospital Clínico Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago (IDIS), Santiago de Compostela, Spain
| | - Sara Manrique-Arija
- UGC de Reumatología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Natalia Mena Vázquez
- UGC de Reumatología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Antonio Fernandez-Nebro
- UGC de Reumatología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Giraud C, Lambert C, Dutheil F, Pereira B, Soubrier M, Tournadre A. The relationship between weight status and metabolic syndrome in patients with rheumatoid arthritis and spondyloarthritis. Joint Bone Spine 2020; 88:105059. [PMID: 32712331 DOI: 10.1016/j.jbspin.2020.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To compare the prevalence and correlates of metabolic syndrome (MetS) stratified by body mass index (BMI) categories in rheumatoid arthritis (RA) and spondyloarthritis (SpA). METHODS The age- and sex-standardized prevalence of MetS was calculated by BMI categories and compared between RA and SpA patients before starting first biologic, and controls. The determinants of metabolic syndrome in patients without obesity were investigated. RESULTS MetS was observed in 28% of RA (21/75), 22.5% of SpA (18/80), 19% of controls (187/998). The age- and sex-standardized prevalence of MetS was not significantly different between RA 19% (95% CI: 11-27%), SpA 26% (95% CI: 16-36%) and controls 16% (95% CI: 14-18%). When stratified by BMI, the standardized prevalence of MetS was less frequent in obese RA patients (15%, 95% CI: 4-27%) compared to obese controls (48%, 95% CI: 40-55%) or to obese SpA (36%, 95% CI: 26-45%). In normal-weight RA patients, MetS standardized prevalence was 16% (95% CI: 7-25%) compared to 5% (95% CI: 0-11%) in SpA, and 6% (95% CI: 4-8%) in controls. In non-obese SpA, MetS was associated with abdominal obesity, visceral fat mass and cardiovascular risk. In non-obese RA patients with metabolic syndrome, body composition did not differ from metabolically healthy RA patients. CONCLUSIONS MetS is not uniform among patients with similar BMI. In RA, MetS was less frequent in obese patients, and unlike SpA, was not associated with body fat composition in non-obese patients. Differences between RA and SpA for metabolic health suggest various pathophysiological mechanisms.
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Affiliation(s)
- Charlotte Giraud
- Rheumatology department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; UNH-UMR 1019, INRAe and University of Clermont-Auvergne, 63003 Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics unit (DRCI), CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Frédéric Dutheil
- Preventive and Occupational Medicine, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- Biostatistics unit (DRCI), CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France
| | - Martin Soubrier
- Rheumatology department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; UNH-UMR 1019, INRAe and University of Clermont-Auvergne, 63003 Clermont-Ferrand, France
| | - Anne Tournadre
- Rheumatology department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France; UNH-UMR 1019, INRAe and University of Clermont-Auvergne, 63003 Clermont-Ferrand, France.
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Mulumba C, Lebughe P, Mbuyi-Muamba JM, Makulo JR, Lepira F, Mukaya J, Westhovens R, Verschueren P, Malemba JJ. Prevalence and associated factors of subclinical atherosclerosis in rheumatoid arthritis at the university hospital of Kinshasa. BMC Rheumatol 2019; 3:37. [PMID: 31517250 PMCID: PMC6732832 DOI: 10.1186/s41927-019-0085-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 08/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is associated with a 5 to 10 years reduction in life expectancy due to premature atherosclerosis. This reduction is the consequence of traditional cardiovascular risk factors (TCRF) as well as systemic inflammation. The aim of the present study was to describe the prevalence and factors associated with subclinical atherosclerosis in RA at the University Hospital of Kinshasa (UHK). Methods Patients with a diagnosis of RA based on the 2010 ACR/EULAR criteria were included in this cross-sectional study from 1 June 2014 to 31 May 2015 at the UHK. RA disease activity was measured using the DAS28-ESR. Active RA was defined by a DAS 28 > 2.6. Severe RA was defined by the presence of extra-articular manifestation, joint erosions on X-rays or HAQ ≥0.5. An assessment of subclinical atherosclerosis was performed by the measurement of the carotid intima-media thickness (cIMT) using two-dimensional ultrasonography. Subclinical atherosclerosis was defined by a cIMT ≥0.9 mm. A diagnosis of atheroma plaque was retained when the cIMT was ≥1.5 mm. The association between subclinical atherosclerosis and potential risk factors was modeled using logistic regression analysis. Results We recruited 75 patients. The average age was 51.8 ± 14.6 years, with a sex ratio F/M of 4. The prevalence of subclinical atherosclerosis was 32%. In logistic regression being a woman of ≥55 years old (aOR 10.6, 95% CI [2.087–53.82], p = 0.028), DAS28-ESR > 2.6 (aOR 3.5,95% CI [1.55–10.38], p = 0.044), severe RA (aOR 32.6,95% CI [1.761–60.37],p = 0.035), high blood pressure (aOR 22.4,95% CI [5.04–99.41], p = 0.005) and obesity (aOR 32.3, 95% CI [2.606–40.73], p = 0.026) emerged as factors associated with subclinical atherosclerosis. Conclusion Subclinical atherosclerosis is common in RA patients attending the UHK. It appears to be associated with RA disease activity and severity apart from traditional cardiovascular risk factors. These results suggest that early management of subclinical atherosclerosis targeting remaining RA disease activity and cardiovascular risk factors could slow down progression to clinical cardiovascular disease.
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Affiliation(s)
- Christophe Mulumba
- Rheumatology Unit, Department of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Pierrot Lebughe
- Rheumatology Unit, Department of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Marie Mbuyi-Muamba
- Rheumatology Unit, Department of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Robert Makulo
- Nephrology Unit, Departement of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - François Lepira
- Nephrology Unit, Departement of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean Mukaya
- Radiology Unit, Department of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Rene Westhovens
- 4Department of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | | | - Jean-Jacques Malemba
- Rheumatology Unit, Department of internal medicine, University Hospital of Kinshasa, Kinshasa, Democratic Republic of Congo
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Sidiropoulos P, Sfikakis PP, Boumpas DD, Vassilopoulos D. Twenty Years of Targeted Treatment in Rheumatoid Arthritis in the Greek Databases: Achievements and Unmet Needs. Mediterr J Rheumatol 2019; 30:141-146. [PMID: 32185356 PMCID: PMC7045862 DOI: 10.31138/mjr.30.3.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/05/2019] [Accepted: 06/22/2019] [Indexed: 11/25/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with substantial morbidity and mortality especially in difficult to treat cases. Biologic agents were introduced 20 years ago in Greece and RA management has paralleled the European experience. Several publications from the country have captured important aspects of the disease from its epidemiology to the clinical use of biologics and management of comorbidities. In this communication we review the management of RA and its evolution over the last 20 years in Greece, discussing the major achievements and the unmet needs of the disease in an effort to put this into a perspective. We conclude that introduction of biologic therapy has substantially changed the treatment of difficult to treat rheumatoid arthritis in-spite of the multiple unmet needs. While striving for even better outcomes, we cannot lose sight of the major impact of biologic therapies on the lives of patients with rheumatoid arthritis.
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Affiliation(s)
- Prodromos Sidiropoulos
- Department of Rheumatology and Clinical Immunology, School of Medicine, University of Crete, Greece
- Laboratory of Rheumatology, Inflammation and Autoimmunity, Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology, Heraklion, Greece
| | - Petros P. Sfikakis
- First Department of Propaedeutic and Internal Medicine & Rheumatology Unit, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Joint Rheumatology Program, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitrios D. Boumpas
- 4th Department of Internal Medicine, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
- Joint Rheumatology Program, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
- Laboratory of Immune Regulation and Tolerance, Autoimmunity and Inflammation, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Dimitrios Vassilopoulos
- 2nd Department of Medicine and Laboratory, Hippokration General Hospital, Medical School, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
- Joint Rheumatology Program, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Kesikburun B, Ekşioğlu E, Çakcı A. Metabolic Syndrome in Rheumatoid Arthritis and Ankylosing Spondylitis. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.435258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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9
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Mobini M, Niksolat F, Mohammadpour RA, Dashti Dargahloo S, Marzban D. Metabolic syndrome in patients with systemic lupus erythematosus: Association with disease activity, disease damage and age. Int J Rheum Dis 2018; 21:1023-1030. [DOI: 10.1111/1756-185x.13276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Maryam Mobini
- Department of Internal Medicine; Diabetes Research Center; Mazandaran University of Medical Sciences; Sari Iran
| | - Fatemeh Niksolat
- Department of Internal Medicine; Orthopedic Research Center; Mazandaran University of Medical Sciences; Sari Iran
| | - Reza Ali Mohammadpour
- Department of Biostatistics; Diabetes Research Center; Mazandaran University of Medical Sciences; Sari Iran
| | | | - Dorsa Marzban
- Faculty of Medicine; Mazandaran University of Medical Sciences; Sari Iran
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Wu D, Hua B, Fang Z, Liu J, Liu N, Ma Y. Adiponectin exerts a potent anti-arthritic effect and insulin resistance in collagen-induced arthritic rats. Int J Rheum Dis 2017; 21:1496-1503. [PMID: 28752573 DOI: 10.1111/1756-185x.13141] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM Previous research has shown that adiponectin (AD) induces severe insulin resistance (IR) and exhibits pro-inflammatory effect, so it could serve as a useful risk biomarker in rheumatoid arthritis (RA). The present study aims to evaluate the effect of AD on IR and anti-arthritis in collagen-induced arthritic (CIA) rats. METHOD After immunization with bovine type II collagen (CII), Wistar rats were administered with AD (60 μg/kg/day) or saline into the ankle joint cavity of the left hind leg for 15 days. The severity of arthritis was clinically and histologically assessed. Arthritis score was recorded every other day for each paw. Paw volume was measured on alternate days to monitor the progression of the disease in the arthritic control group. Tumor necrosis factor (TNF)-α, interleukin (IL)-1, AD, insulin and fasting glucose were measured in sera. Histopathology of joint synovial tissues was also examined. RESULTS Treatment with AD resulted in significantly delayed onset of arthritis as well as decreased clinical arthritis and histopathological severity scores. AD reduced both serum fasting glucose, TNF-α, IL-1 and IR. Histological analysis confirmed treatment with AD suppressed joint synovial inflammation and immunohistochemical expression of TNF-α compared to the CIA group. Surprisingly, adiponectin levels measured by enzyme-linked immunosorbent assay in serum were significantly increased in CIA rats compared to the normal group. CONCLUSIONS Adiponectin might display anti-inflammatory effects. These results suggest that AD may be a potential immunosuppressant for the treatment of RA linked to metabolic disease.
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Affiliation(s)
- Dongke Wu
- Department of Internal Clinical Medicine, the first Affiliated Hospital of Nanchang University, Nanchang, China
| | - Binghong Hua
- The Medical School of Nanchang University, Nanchang, China
| | - Zishui Fang
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Jiankun Liu
- The Medical School of Nanchang University, Nanchang, China
| | - Ningning Liu
- The Medical School of Nanchang University, Nanchang, China
| | - Yunqing Ma
- Department of Internal Clinical Medicine, the first Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Rheumatology, UTHealth Medical School at Houston, Houston, Texas, USA
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Hallajzadeh J, Safiri S, Mansournia MA, Khoramdad M, Izadi N, Almasi-Hashiani A, Pakzad R, Ayubi E, Sullman MJM, Karamzad N. Metabolic syndrome and its components among rheumatoid arthritis patients: A comprehensive updated systematic review and meta-analysis. PLoS One 2017; 12:e0170361. [PMID: 28333949 PMCID: PMC5363810 DOI: 10.1371/journal.pone.0170361] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 01/03/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Estimating the current global prevalence of metabolic syndrome (MetS), and its components, among rheumatoid arthritis (RA) patients is necessary in order to formulate preventative strategies and to ensure there are adequate community resources available for these patients. Furthermore, the association between RA and MetS is controversial and has not previously been comprehensively assessed. Therefore, the present study aimed to: 1) determine the prevalence of MetS, and its components, among RA patients across the world 2) update the odds ratio of MetS in RA patients, compared to healthy controls, using a comprehensive systematic review and meta-analysis. METHODS International databases, including: the Web of Science, PubMed, Scopus, Embase, CINAHL and other relevant databases were searched to identify English language articles which reported the prevalence and risk of MetS in RA patients between January 2000 and August 2016. The meta-analysis only included studies which clearly described the time and location of the study, utilised adequate sampling strategies, and appropriate statistical analyses. RESULTS The meta-analyses of prevalence (70 studies [n = 12612]) and risk (43 studies [n = 35220]) of MetS in RA patients were undertaken separately. The overall pooled prevalence of MetS was 30.65% (95% CI: 27.87-33.43), but this varied from 14.32% (95% CI: 10.59-18.05) to 37.83% (95% CI: 31.05-44.61), based upon the diagnostic criteria used. The prevalence of MetS also varied slightly between males (31.94%, 95% CI: 24.37-39.51) and females (33.03%, 95% CI: 28.09-37.97), but this was not statistically significant. The overall pooled odds ratio (OR) of MetS in RA patients, compared to healthy controls, was 1.44 (95% CI: 1.20-1.74), but this ranged from 0.70 (95% CI: 0.27-1.76) to 4.09 (95% CI: 2.03-8.25), depending on the criteria used. The mean age and diagnostic criteria of MetS were identified as sources of heterogeneity in the estimated odds ratios between studies (P<0.05). CONCLUSIONS According to the high prevalence of MetS in RA patients, and high risk of MetS, measuring metabolic syndrome in RA patients is strongly recommended. Furthermore, as high waist circumference (WC) is the most common metabolic syndrome component, more attention must be paid to nutrition and weight loss among those with RA.
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Affiliation(s)
- Jamal Hallajzadeh
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Saeid Safiri
- Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maliheh Khoramdad
- Department of Epidemiology and Biostatistics, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Neda Izadi
- Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Centre, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Reza Pakzad
- Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Erfan Ayubi
- Department of Public Health, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran
| | - Mark J. M. Sullman
- Driving Research Group, Cranfield University, Bedfordshire, United Kingdom
| | - Nahid Karamzad
- Vice-Chancellery for Food and Drug, Maragheh University of Medical Sciences, Maragheh, Iran
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12
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Rodríguez-Carrio J, López P, Sánchez B, González S, Gueimonde M, Margolles A, de Los Reyes-Gavilán CG, Suárez A. Intestinal Dysbiosis Is Associated with Altered Short-Chain Fatty Acids and Serum-Free Fatty Acids in Systemic Lupus Erythematosus. Front Immunol 2017; 8:23. [PMID: 28167944 PMCID: PMC5253653 DOI: 10.3389/fimmu.2017.00023] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 01/05/2017] [Indexed: 12/21/2022] Open
Abstract
Metabolic impairments are a frequent hallmark of systemic lupus erythematosus (SLE). Increased serum levels of free fatty acids (FFA) are commonly found in these patients, although the underlying causes remain elusive. Recently, it has been suggested that factors other than inflammation or clinical features may be involved. The gut microbiota is known to influence the host metabolism, the production of short-chain fatty acids (SCFA) playing a potential role. Taking into account that lupus patients exhibit an intestinal dysbiosis, we wondered whether altered FFA levels may be associated with the intestinal microbial composition in lupus patients. To this aim, total and specific serum FFA levels, fecal SCFA levels, and gut microbiota composition were determined in 21 SLE patients and 25 healthy individuals. The Firmicutes to Bacteroidetes (F/B) ratio was strongly associated with serum FFA levels in healthy controls (HC), even after controlling for confounders. However, this association was not found in lupus patients, where a decreased F/B ratio and increased FFA serum levels were noted. An altered production of SCFA was related to the intestinal dysbiosis in lupus, while SCFA levels paralleled those of serum FFA in HC. Although a different serum FFA profile was not found in SLE, specific FFA showed distinct patterns on a principal component analysis. Immunomodulatory omega-3 FFA were positively correlated to the F/B ratio in HC, but not in SLE. Furthermore, divergent associations were observed for pro- and anti-inflammatory FFA with endothelial activation biomarkers in lupus patients. Overall, these findings support a link between the gut microbial ecology and the host metabolism in the pathological framework of SLE. A potential link between intestinal dysbiosis and surrogate markers of endothelial activation in lupus patients is supported, FFA species having a pivotal role.
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Affiliation(s)
- Javier Rodríguez-Carrio
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Patricia López
- Area of Immunology, Department of Functional Biology, University of Oviedo , Oviedo, Asturias , Spain
| | - Borja Sánchez
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Sonia González
- Area of Physiology, Department of Functional Biology, University of Oviedo , Oviedo, Asturias , Spain
| | - Miguel Gueimonde
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Abelardo Margolles
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Clara G de Los Reyes-Gavilán
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias (IPLA-CSIC) , Villaviciosa, Asturias , Spain
| | - Ana Suárez
- Area of Immunology, Department of Functional Biology, University of Oviedo , Oviedo, Asturias , Spain
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Serum ghrelin levels in patients with Behcet's disease. Postepy Dermatol Alergol 2016; 33:450-456. [PMID: 28035223 PMCID: PMC5183784 DOI: 10.5114/ada.2016.63884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 11/12/2015] [Indexed: 01/23/2023] Open
Abstract
Introduction Behcet’s disease (BD) is a chronic, relapsing, systemic vasculitis of unknown etiology. Aim To measure serum ghrelin levels in BD patients and healthy controls and to investigate its association with metabolic syndrome (MetS). Material and methods Thirty BD patients and 30 healthy individuals were enrolled in the study. Ghrelin levels were measured in blood samples using ELISA. Results The mean serum ghrelin level in BD patients (28.57 ±14.04) was significantly lower compared to healthy controls (40.72 ±23.21) (p = 0.01). The mean serum ghrelin level in BD patients who had MetS (24.18 ±12.73) was lower compared to BD patients who did not have MetS (30.77 ±14.45), but this difference was not significant (p > 0.05). Conclusions Ghrelin levels were lower in BD patients compared to healthy controls. There was no association between reduced ghrelin levels and MetS; however, there was a negative correlation between ghrelin levels and disease activity.
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Silva MG, Borba EF, de Mello SBV, Shinjo SK. Serum adipocytokine profile and metabolic syndrome in young adult female dermatomyositis patients. Clinics (Sao Paulo) 2016; 71:709-714. [PMID: 28076515 PMCID: PMC5175289 DOI: 10.6061/clinics/2016(12)06] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 09/05/2016] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES: To analyse the frequency of metabolic syndrome in young adult female dermatomyositis patients and its possible association with clinical and laboratory dermatomyositis-related features and serum adipocytokines. METHOD: This cross-sectional study included 35 dermatomyositis patients and 48 healthy controls. Metabolic syndrome was defined according to the 2009 Joint Interim Statement. RESULTS: Patient age was comparable in the dermatomyositis and control groups, and the median disease duration was 1.0 year. An increased prevalence of metabolic syndrome was detected in the dermatomyositis group (34.3% vs. 6.3%; p=0.001). In addition, increased serum adiponectin and resistin levels were noted in contrast to lower leptin levels. In dermatomyositis patients, adipocytokine levels were correlated with the levels of total cholesterol, low-density cholesterol, triglycerides and muscle enzymes. A comparison of dermatomyositis patients with (n=12) and without (n=23) syndrome metabolic revealed that adipocytokine levels were also correlated with age, and that dermatomyositis patients with metabolic syndrome tended to have more disease activity despite similar adipocytokine levels. CONCLUSIONS: Metabolic syndrome is highly prevalent in young adult female dermatomyositis patients and is related to age and disease activity. Moreover, increased serum adiponectin and resistin levels were detected in dermatomyositis patients, but lower serum leptin levels were observed.
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Affiliation(s)
- Marilda Guimarães Silva
- Faculdade de Medicina da Universidade de São Paulo, Clínica Médica, Reumatologia, São Paulo/SP, Brazil
| | - Eduardo Ferreira Borba
- Faculdade de Medicina da Universidade de São Paulo, Clínica Médica, Reumatologia, São Paulo/SP, Brazil
| | | | - Samuel Katsuyuki Shinjo
- Faculdade de Medicina da Universidade de São Paulo, Clínica Médica, Reumatologia, São Paulo/SP, Brazil
- E-mail:
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Cardiovascular risk assessment in patients with rheumatoid arthritis: The relevance of clinical, genetic and serological markers. Autoimmun Rev 2016; 15:1013-1030. [DOI: 10.1016/j.autrev.2016.07.026] [Citation(s) in RCA: 87] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/09/2016] [Indexed: 12/11/2022]
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Przepiera-Będzak H, Fischer K, Brzosko M. Serum Interleukin-18, Fetuin-A, Soluble Intercellular Adhesion Molecule-1, and Endothelin-1 in Ankylosing Spondylitis, Psoriatic Arthritis, and SAPHO Syndrome. Int J Mol Sci 2016; 17:ijms17081255. [PMID: 27527149 PMCID: PMC5000653 DOI: 10.3390/ijms17081255] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 07/27/2016] [Accepted: 07/27/2016] [Indexed: 01/05/2023] Open
Abstract
To examine serum interleukin 18 (IL-18), fetuin-A, soluble intercellular adhesion molecule-1 (sICAM-1), and endothelin-1 (ET-1) levels in ankylosing spondylitis (AS), psoriatic arthritis (PsA), and Synovitis Acne Pustulosis Hyperostosis Osteitis syndrome (SAPHO). We studied 81 AS, 76 PsA, and 34 SAPHO patients. We measured serum IL-18, fetuin-A, sICAM-1, ET-1, IL-6, IL-23, vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF). IL-18 levels were higher in AS (p = 0.001), PsA (p = 0.0003), and SAPHO (p = 0.01) than in controls, and were positively correlated with CRP (p = 0.03), VEGF (p = 0.03), and total cholesterol (TC, p = 0.006) in AS and with IL-6 (p = 0.03) in PsA. Serum fetuin-A levels were lower in AS (p = 0.001) and PsA (p = 0.001) than in controls, and negatively correlated with C-reactive protein (CRP) in AS (p = 0.04) and SAPHO (p = 0.03). sICAM-1 positively correlated with CRP (p = 0.01), erythrocyte sedimentation rate (ESR, p = 0.01), and IL-6 (p = 0.008) in AS, and with IL-6 (p = 0.001) in SAPHO. Serum ET-1 levels were lower in AS (p = 0.0005) than in controls. ET-1 positively correlated with ESR (p = 0.04) and Disease Activity Score 28 (DAS28, p = 0.003) in PsA. In spondyloarthritis, markers of endothelial function correlated with disease activity and TC.
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Affiliation(s)
- Hanna Przepiera-Będzak
- Department of Rheumatology, Internal Medicine and Geriatrics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, Szczecin 71-252, Poland.
| | - Katarzyna Fischer
- Independent Laboratory of Rheumatic Diagnostics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, Szczecin 71-252, Poland.
| | - Marek Brzosko
- Department of Rheumatology, Internal Medicine and Geriatrics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, Szczecin 71-252, Poland.
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Lee SH, Choi H, Cho BL, An AR, Seo YG, Jin HS, Oh SM, Jang SH. Relationship between Metabolic Syndrome and Rheumatoid Arthritis. Korean J Fam Med 2016; 37:44-50. [PMID: 26885322 PMCID: PMC4754286 DOI: 10.4082/kjfm.2016.37.1.44] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 09/08/2015] [Indexed: 11/23/2022] Open
Abstract
Background Rheumatoid arthritis (RA) and metabolic syndrome (Mets) are considered to be diseases with common traits that can increase the risk of cardiovascular disease incidence; studies in other countries examined the relationship between these diseases. However, existing studies did not show consistent results. In the present study, the relationship between RA and Mets in Koreans was examined using the data of the 4th and 5th Korea National Health and Nutrition Examination Survey (KNHANES). Methods The present study used the data of the 4th and 5th KNHANES, conducted between 2007 and 2012. Among 25,812 adults aged over 40, 19,893 were selected as study subjects, excluding 5,919 who did not have variable information needed for the analysis. T-test and chi-square test were used for the analysis of related variables. To determine the relationship between diagnostic status of RA and Mets, multivariate logistic regression analysis was performed by controlling confounding variables, which were selected through literature review and statistical analysis. Results Multivariate logistic regression analysis was conducted to examine the relationship between diagnostic status of RA and Mets. When age, education level, average monthly household income, smoking, alcohol consumption, and level of physical activity were adjusted, the prevalence of Mets was lower in RA patients (adjusted odds ratio [aOR], 0.79; 95% confidence interval [CI], 0.65 to 0.96). Multivariate logistic regression analysis was performed to examine the relationship between treatment status of RA and Mets. When age, education level, average monthly household income, smoking, alcohol consumption, and level of physical activity were adjusted, there was a significant negative correlation in women (aOR, 0.65; 95% CI, 0.44 to 0.96). Conclusion The relationship between RA and Mets showed a significantly negative correlation in Korean women. The group that received RA treatment showed significantly lower prevalence of the Mets as compared to the untreated group in Korean RA women.
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Affiliation(s)
- Sang-Hyun Lee
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hochun Choi
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Be-Long Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ah-Reum An
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Young-Gyun Seo
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Ho-Seong Jin
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seung-Min Oh
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Soo Hyun Jang
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
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18
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Metaflammatory responses during obesity: Pathomechanism and treatment. Obes Res Clin Pract 2015; 10:103-13. [PMID: 26614484 DOI: 10.1016/j.orcp.2015.10.012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 10/07/2015] [Accepted: 10/30/2015] [Indexed: 12/11/2022]
Abstract
Obesity induced inflammation acts as a reflex produced due to altered metabolic homeostasis in accordance to the nutrient overload on the metabolic cells. It involves up-regulation of the genes encoding for cytokines, chemokines and other inflammatory mediators through activated transcription factors - nuclear factor-kB, activator protein-1, nuclear factor of activated T cells and signal transducer and activator of transcription 3. These execute macromolecular innate immune cell sensor - inflammasome to activate caspase-1 pathway resulting in proteolytic maturation. Secretion of pro-inflammatory cytokines including TNF-α, IL-6, CRP, IL-1β, etc. from the M1 macrophages of white adipose tissue is increased, whereas there occurs a steep decline in the production of anti-inflammatory cytokines like IL-10, IL-Ra, adiponectin. Not only the adipose tissue, but also the immune cells, liver, brain, muscles and pancreas suffers from the inflammatory insult during obese condition and are exaggeratedly affected. The inflammatory kinases like JNK and IKK apart from inhibiting insulin action and glucose uptake, down-regulate transcriptional process resulting in increased expression of pro-inflammatory cytokines. Macrophage-like Kupffer cells initiate the inflammatory process in the liver preceding the inflammatory signals produced by the white adipose tissue which may further lead to hepatic-necro-inflammation. The muscle-fibre is affected by the cytokines and therefore results in decreased glycogen synthesis. The triggered hypothalamic-pituitary-adrenal axis further affects the expression of inflammatory cytokines thus altering insulin homeostasis and initiating glucose intolerance. Anti-inflammatory treatment so as to curb the severity of inflammatory responses includes administration of synthetic drugs to target the actual inflammatory molecules and various therapeutic interventions.
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Muniz LF, Pereira RMR, Silva TF, Bonfá E, Borba EF. Impact of Therapy on Metabolic Syndrome in Young Adult Premenopausal Female Lupus Patients: Beneficial Effect of Antimalarials. Arthritis Care Res (Hoboken) 2015; 67:1255-1262. [DOI: 10.1002/acr.22593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/18/2015] [Accepted: 03/24/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Luciana F. Muniz
- Faculdade de Medicina da Universidade de Sao PauloSao Paulo Brazil
| | | | - Thiago F. Silva
- Faculdade de Medicina da Universidade de Sao PauloSao Paulo Brazil
| | - Eloisa Bonfá
- Faculdade de Medicina da Universidade de Sao PauloSao Paulo Brazil
| | - Eduardo F. Borba
- Faculdade de Medicina da Universidade de Sao PauloSao Paulo Brazil
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20
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Baraka E, El Dein M, Farouk H, El Moutaz Y. Hyperhomocysteinemia and metabolic syndrome are risk factors for sub-clinical atherosclerosis in women with systemic lupus erythematosus. EGYPTIAN RHEUMATOLOGIST 2015. [DOI: 10.1016/j.ejr.2014.07.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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21
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Metabolic changes and serum ghrelin level in patients with psoriasis. Dermatol Res Pract 2015; 2014:175693. [PMID: 25587268 PMCID: PMC4281451 DOI: 10.1155/2014/175693] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 12/02/2014] [Accepted: 12/08/2014] [Indexed: 02/08/2023] Open
Abstract
Background. Serum ghrelin levels may be related to metabolic and clinical changes in patients with psoriasis. Objective. This study was performed to determine the possible effects of serum ghrelin in patients with psoriasis. Methods. The study population consisted of 25 patients with plaque psoriasis. The patients were questioned with regard to age, gender, age of onset, duration of disease, height, weight, and body mass index (BMI). In addition, fasting blood sugar, triglyceride, cholesterol levels, insulin, and ghrelin levels were measured. Results. The mean serum ghrelin level was 45.41 ± 22.41 in the psoriasis group and 29.92 ± 14.65 in the healthy control group. Serum ghrelin level was significantly higher in the psoriasis group compared with the controls (P = 0.01). The mean ghrelin level in patients with a lower PASI score was significantly higher than in those with a higher PASI score (P = 0.02). Conclusion. The present study was performed to determine the effects of ghrelin in psoriasis patients. We found a negative correlation between severity of psoriasis and ghrelin level. Larger and especially experimental studies focusing on correlation of immune system-ghrelin levels and severity of psoriasis may be valuable to clarify the etiopathogenesis of the disease.
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Prevalence of metabolic syndrome in patients with rheumatoid arthritis in Morocco: a cross-sectional study of 179 cases. Clin Rheumatol 2014; 33:1549-55. [DOI: 10.1007/s10067-014-2570-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 02/22/2014] [Accepted: 03/01/2014] [Indexed: 10/25/2022]
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Abella V, Scotece M, Conde J, López V, Lazzaro V, Pino J, Gómez-Reino JJ, Gualillo O. Adipokines, metabolic syndrome and rheumatic diseases. J Immunol Res 2014; 2014:343746. [PMID: 24741591 PMCID: PMC3987880 DOI: 10.1155/2014/343746] [Citation(s) in RCA: 103] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 01/10/2014] [Accepted: 01/10/2014] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome (MetS) is a cluster of cardiometabolic disorders that result from the increasing prevalence of obesity. The major components of MetS include insulin resistance, central obesity, dyslipidemia, and hypertension. MetS identifies the central obesity with increased risk for cardiovascular diseases (CVDs) and type-2 diabetes mellitus (T2DM). Patients with rheumatic diseases, such as rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus, and ankylosing spondylitis, have increased prevalence of CVDs. Moreover, CVD risk is increased when obesity is present in these patients. However, traditional cardiovascular risk factors do not completely explain the enhanced cardiovascular risk in this population. Thus, MetS and the altered secretion patterns of proinflammatory adipokines present in obesity could be the link between CVDs and rheumatic diseases. Furthermore, adipokines have been linked to the pathogenesis of MetS and its comorbidities through their effects on vascular function and inflammation. In the present paper, we review recent evidence of the role played by adipokines in the modulation of MetS in the general population, and in patients with rheumatic diseases.
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Affiliation(s)
- Vanessa Abella
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain ; Department of Molecular and Cellular Biology, University of Coruña (UDC), 15071 A Coruña, Spain
| | - Morena Scotece
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Javier Conde
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Verónica López
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Verónica Lazzaro
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain ; University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Jesús Pino
- SERGAS, Division of Orthopaedics Surgery and Traumatology, Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Juan J Gómez-Reino
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
| | - Oreste Gualillo
- SERGAS, Research Laboratory 9, NEIRID Lab (Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical Research (IDIS), Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain
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Pehlevan S, Yetkin DO, Bahadır C, Goktay F, Pehlevan Y, Kayatas K, Ince N. Increased Prevalence of Metabolic Syndrome in Patients with Psoriatic Arthritis. Metab Syndr Relat Disord 2014; 12:43-8. [DOI: 10.1089/met.2013.0039] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Seval Pehlevan
- Department of Rheumatology, Fatih University Sema Hospital, Istanbul, Turkey
| | | | - Cengiz Bahadır
- Department of Physical Therapy and Rehabilitation, Erenkoy Physical Therapy and Rehabilitation Hospital, Istanbul, Turkey
| | - Fatih Goktay
- Department of Dermatology, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey
| | - Yekta Pehlevan
- Department of Physical Therapy and Rehabilitation, Pendik State Hospital, Istanbul, Turkey
| | - Kadir Kayatas
- Department of Internal Medicine, Haydarpasa Numune Education and Training Hospital, Istanbul, Turkey
| | - Nurhan Ince
- Department of Public Health, Istanbul Medical Faculty, University of Istanbul, Istanbul, Turkey
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25
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Prevalence and Correlates of Metabolic Syndrome in Patients With Rheumatoid Arthritis in Argentina. J Clin Rheumatol 2013; 19:439-43. [DOI: 10.1097/rhu.0000000000000039] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Paul BJ, Rahim AA, Bina T, Thekkekara RJ. Prevalence and factors related to rheumatic musculoskeletal disorders in rural south India: WHO-ILAR-COPCORD-BJD India Calicut study. Int J Rheum Dis 2013; 16:392-7. [DOI: 10.1111/1756-185x.12105] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Binoy J. Paul
- Department of Medicine and Rheumatology; Government Medical College; Calicut India
| | - Asma A. Rahim
- Department of Community Medicine; Government Medical College; Calicut India
| | - Thomas Bina
- Department of Community Medicine; Government Medical College; Calicut India
| | - Romy J. Thekkekara
- Department of Community Medicine; Government Medical College; Calicut India
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de Moraes MT, de Souza FHC, de Barros TBM, Shinjo SK. Analysis of Metabolic Syndrome in Adult Dermatomyositis With a Focus on Cardiovascular Disease. Arthritis Care Res (Hoboken) 2013; 65:793-9. [DOI: 10.1002/acr.21879] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 10/05/2012] [Indexed: 11/06/2022]
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Lee SG, Kim JM, Lee SH, Kim KH, Kim JH, Yi JW, Jung WJ, Park YE, Park SH, Lee JW, Baek SH, Lee JH, Kim GT. Is the frequency of metabolic syndrome higher in South Korean women with rheumatoid arthritis than in healthy subjects? Korean J Intern Med 2013; 28:206-15. [PMID: 23526131 PMCID: PMC3604611 DOI: 10.3904/kjim.2013.28.2.206] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Revised: 08/29/2012] [Accepted: 08/31/2012] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIMS To compare the frequency of metabolic syndrome (MetS) and magnitude of insulin resistance, measured by the homeostatic model assessment of insulin resistance (HOMA-IR), between South Korean women with rheumatoid arthritis (RA) and healthy subjects, and to evaluate risk factors for MetS and increased HOMA-IR in patients with RA. METHODS In a cross-sectional setting, 84 female patients with RA and 109 age-matched healthy female subjects were consecutively recruited at a university-affiliated rheumatology center in South Korea. MetS was defined according to the Third Report of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP III) 2004 criteria. RESULTS The frequency of MetS did not differ significantly between patients with RA (19%) and healthy subjects (15.6%, p = 0.566), although patients with RA had a higher HOMA-IR compared with healthy subjects (p < 0.001). Patients with RA met the NCEP-ATP III 2004 criteria for high blood pressure more often than healthy subjects (44% vs. 19.3%, p < 0.001), and low high density lipoprotein cholesterol was more prevalent in healthy subjects (33%) than in patients with RA (14.3%, p = 0.004). Although no obvious risk factors for the presence of MetS were identified in patients with RA, higher serum C-reactive protein and disease activity score assessed using the 28-joint count for swelling and tenderness-erythrocyte sedimentation rate significantly contributed to a higher HOMA-IR. CONCLUSIONS Despite their increased insulin resistance, South Korean women with RA did not have a significantly higher frequency of MetS compared with that in healthy subjects.
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Affiliation(s)
- Seung-Geun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ji-Min Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sun-Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kye-Hyung Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ji-Hye Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ji-Won Yi
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Woo-Jin Jung
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Young-Eun Park
- Department of Internal Medicine, Malgeunsem Hospital, Changwon, Korea
| | - Seong-Hu Park
- Department of Internal Medicine, Young Do Hospital, Busan, Korea
| | - Joung-Wook Lee
- Department of Internal Medicine, Busan St. Mary's Medical Center, Busan, Korea
| | - Seung-Hoon Baek
- Department of Internal Medicine, Ilsin Christian Hospital, Busan, Korea
| | - Jun-Hee Lee
- Department of Internal Medicine, Ilsin Christian Hospital, Busan, Korea
| | - Geun-Tae Kim
- Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Zindancı I, Albayrak O, Kavala M, Kocaturk E, Can B, Sudogan S, Koç M. Prevalence of metabolic syndrome in patients with psoriasis. ScientificWorldJournal 2012; 2012:312463. [PMID: 22654590 PMCID: PMC3349331 DOI: 10.1100/2012/312463] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 12/21/2011] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory skin disorder in which proinflammatory cytokines including IL-6 and TNF-α increase both locally and systematically. It is thought that chronic inflammation results in metabolic diseases and proinflammatory cytokines give rise to the development of atherogenesis, peripheral insulin resistance, hypertension, and type 2 diabetes. Our aim was to investigate the prevalence of metabolic syndrome in patients with psoriasis vulgaris. METHODS Study consisted of 115 plaque-type psoriasis patients and 140 healthy individuals. Data including body weight, height, waist circumference, body-mass index, and arterial blood pressure were collected. Fasting blood glucose, triglyceride, and HDL levels were determined. International Diabetes Federation Criteria for Metabolic Syndrome and Insulin Resistance were used for evaluating patients with metabolic syndrome and diabetes. RESULTS Compared to the control group, metabolic syndrome, diabetes mellitus, and hypertension were found to be higher in psoriasis patients. Metabolic syndrome was increased by 3-folds in psoriasis patients and was more prevalent in women than in men. It was determined that the prevalence of metabolic syndrome was higher in psoriasis patients after the age of 40. Metabolic syndrome was not related to smoking, severity of psoriasis, and duration of disease. CONCLUSIONS Our findings suggest that psoriasis preconditions occurrence of a group of diseases such as diabetes mellitus, hypertension, and metabolic syndrome. For this reason, patients with psoriasis should be treated early and they should be followed with respect to metabolic diseases.
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Affiliation(s)
- Ilkin Zindancı
- Department of Dermatology, Goztepe Training and Research Hospital, Istanbul, Turkey.
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Lee SG, Kim JM, Lee SH, Kim KH, Choi SA, Park EK, Jung WJ, Park YE, Park SH, Lee JW, Baek SH, Lee JH, Kim GT. Frequency of Metabolic Syndrome in Female Patients with Systemic Sclerosis: A Preliminary Report. JOURNAL OF RHEUMATIC DISEASES 2012. [DOI: 10.4078/jrd.2012.19.5.262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Seung-Geun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Ji-Min Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sun-Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Kye-Hyung Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Sang-A Choi
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Eun-Kyoung Park
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Woo-Jin Jung
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Young-Eun Park
- Department of Internal Medicine, Malgeunsem Hospital, Changwon, Korea
| | - Seong-Hu Park
- Department of Internal Medicine, Young-do Hospital, Busan, Korea
| | - Joung-Wook Lee
- Department of Internal Medicine, Busan St. Mary's Medical Center, Busan, Korea
| | - Seung-Hoon Baek
- Department of Internal Medicine, Ilsin Christian Hospital, Busan, Korea
| | - Jun-Hee Lee
- Department of Internal Medicine, Ilsin Christian Hospital, Busan, Korea
| | - Geun-Tae Kim
- Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea
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Jun JB. The Frequency of Metabolic Syndrome in Patients with Systemic Sclerosis. JOURNAL OF RHEUMATIC DISEASES 2012. [DOI: 10.4078/jrd.2012.19.6.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Jae-Bum Jun
- Hanyang University, Hospital for Rheumatic Diseases, Seoul, Korea
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Khosravi A, Akhavan Tabib A, Golshadi I, Dana Siadat Z, Bahonar A, Zarfeshani S, Alikhasi H, Rezaee S, Noori F, Hashemi Jazi M, Khosravi Z. The Relationship between Weight and CVD Risk Factors in a Sample Population from Central Iran (Based on IHHP). ARYA ATHEROSCLEROSIS 2012; 8:82-9. [PMID: 23056109 PMCID: PMC3463990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 04/13/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Atherosclerosis is one of the leading causes of mortality all around the world. Obesity is an independent risk factor for atherosclerosis and cardiovascular diseases (CVD). In this respect, we decided to examine the effect of the subgroups of weight on cardiovascular risk factors. METHODS This cross-sectional study was done in 2006 using the data obtained by the Iranian Healthy Heart Program (IHHP) and based on classification of obesity by the World Health Organization (WHO). In this study, the samples were tested based on the Framingham risk score, Metabolic Measuring Score (MMS) and classification of obesity. Chi-square and ANOVA were used for statistical analysis. RESULTS 12514 people with a mean age of 38 participated in this study. 6.8% of women and 14% of men had university degrees (higher than diploma). Obesity was seen in women more than men: 56.4% of women and 40% of men had a Body Mass Index of (BMI) ≥ 25 Kg/m2. 13% of the subjects had FBS > 110 and13.9% of them were using hypertensive drugs. In this study, we found that all risk factors, except HDL cholesterol in men, increased with an increase in weight. This finding is also confirmed by the Framingham flowfigure for men and women. CONCLUSION One of every two Americans, of any age and sex, has a Body Mass Index of (BMI) ≥ 25 Kg/m2. Obesity associated CVD and other serious diseases. Many studies have been done in different countries to find the relationship between obesity and CVD risk factors. For example, in the U.S.A and Canada they found that emteropiotic parameters, blood presser and lipids increased by age(of both sexes). Moreover, another study done in China, which is a country in Asia like Iran, shows that BMI has an indirect effect on HDL cholesterol, LDL cholesterol and triglyceride. This data is consistent with the results of the current study. However, In China they found that this relationship in men is stronger than women, but our study reveals the opposite.
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Affiliation(s)
- Alireza Khosravi
- Associate Professor, Isfahan Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical
| | - Afshan Akhavan Tabib
- General Practitioner, Isfahan Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of,Afshan Akhavan Tabib,
| | - Imandokht Golshadi
- BSc, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Dana Siadat
- Specialist in Community Medicine, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Bahonar
- General Practitioner, Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sonia Zarfeshani
- BSc, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hassan Alikhasi
- Nutritionist, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahrzad Rezaee
- BSc, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Noori
- BSc, Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hashemi Jazi
- Associate Professor, Isfahan Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical
| | - Zahra Khosravi
- Researcher, Isfahan Hypertension Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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Lago F, Gómez R, Conde J, Scotece M, Gómez-Reino JJ, Gualillo O. Cardiometabolic comorbidities and rheumatic diseases: focus on the role of fat mass and adipokines. Arthritis Care Res (Hoboken) 2011; 63:1083-90. [PMID: 21523926 DOI: 10.1002/acr.20488] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Francisca Lago
- Santiago University Clinical Hospital, Institute of Medical Research, Santiago de Compostela, Spain
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Innes KE, Selfe TK, Agarwal P. Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: a systematic review. Sleep Med Rev 2011; 16:309-39. [PMID: 21733722 DOI: 10.1016/j.smrv.2011.04.001] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 04/07/2011] [Accepted: 04/11/2011] [Indexed: 01/20/2023]
Abstract
Restless legs syndrome (RLS) is a distressing sleep and sensorimotor disorder that affects a large percentage of adults in the western industrialized world and is associated with profound reductions in quality of life. However, the etiology of RLS remains incompletely understood. Enhanced understanding regarding both the antecedents and sequelae of RLS could shed new light on the pathogenesis of RLS. Evidence from an emerging body of literature suggests associations between RLS and diabetes, hypertension, obesity, and related conditions linked to sympathetic activation and metabolic dysregulation, raising the possibility that these factors may likewise play a significant role in the development and progression of RLS, and could help explain the recently documented associations between RLS and subsequent cardiovascular disease. However, the relation between RLS and these chronic conditions has received relatively little attention to date, although potential implications for the pathogenesis and treatment of RLS could be considerable. In this paper, we systematically review the recently published literature regarding the association of RLS to cardiovascular disease and related risk factors characterized by sympathoadrenal and metabolic dysregulation, discuss potential underlying mechanisms, and outline some possible directions for future research.
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Affiliation(s)
- Kim E Innes
- Department of Community Medicine, West Virginia University School of Medicine, PO Box 9190, Morgantown, WV 26506-9190, USA.
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Abstract
The modern rise in obesity and its strong association with insulin resistance and type 2 diabetes have elicited interest in the underlying mechanisms of these pathologies. The discovery that obesity itself results in an inflammatory state in metabolic tissues ushered in a research field that examines the inflammatory mechanisms in obesity. Here, we summarize the unique features of this metabolic inflammatory state, termed metaflammation and defined as low-grade, chronic inflammation orchestrated by metabolic cells in response to excess nutrients and energy. We explore the effects of such inflammation in metabolic tissues including adipose, liver, muscle, pancreas, and brain and its contribution to insulin resistance and metabolic dysfunction. Another area in which many unknowns still exist is the origin or mechanism of initiation of inflammatory signaling in obesity. We discuss signals or triggers to the inflammatory response, including the possibility of endoplasmic reticulum stress as an important contributor to metaflammation. Finally, we examine anti-inflammatory therapies for their potential in the treatment of obesity-related insulin resistance and glucose intolerance.
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Affiliation(s)
- Margaret F Gregor
- Departments of Genetics and Complex Diseases and Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA
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Kontunen P, Vuolteenaho K, Nieminen R, Lehtimäki L, Kautiainen H, Kesäniemi YA, Ukkola O, Kauppi M, Hakala M, Moilanen E. Resistin is linked to inflammation, and leptin to metabolic syndrome, in women with inflammatory arthritis. Scand J Rheumatol 2011; 40:256-62. [DOI: 10.3109/03009742.2010.548827] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Karimi M, Mazloomzadeh S, Kafan S, Amirmoghadami H. The frequency of metabolic syndrome in women with rheumatoid arthritis and in controls. Int J Rheum Dis 2011; 14:248-54. [PMID: 21816020 DOI: 10.1111/j.1756-185x.2011.01595.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM To compare the frequency of the metabolic syndrome and its components in a sample of patients with rheumatoid arthritis (RA) and controls. METHODS This case control study was performed on 188 women over 18 years old: 92 RA patients and 96 healthy controls, from 2006 to 2008. Blood pressure, height, weight and waist circumference were measured. Blood was collected for the measurement of fasting glucose, lipid profile and insulin. The frequency of the metabolic syndrome was determined in case and control groups, using both WHO and National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. RESULTS According to the NCEP criteria, the frequency of metabolic syndrome in RA patients and controls were 27.2% and 35.4%, respectively (P = 0.22). Based on WHO criteria, 19.6% of RA patients and 21.9% of the control group were subject to metabolic syndrome (P = 0.70). The proportion with hypertension was greater in RA patients than the control group. The duration of RA was significantly higher in patients with metabolic syndrome compared to those without metabolic syndrome using both the WHO and NCEP criteria. CONCLUSIONS There was no evidence of a greater prevalence of metabolic syndrome in RA patients compared with controls in this study. The duration of RA was associated with metabolic syndrome, implicating the role of inflammation in metabolic syndrome development.
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Affiliation(s)
- Marjaneh Karimi
- Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
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Crowson CS, Myasoedova E, Davis JM, Matteson EL, Roger VL, Therneau TM, Fitz-Gibbon P, Rodeheffer RJ, Gabriel SE. Increased prevalence of metabolic syndrome associated with rheumatoid arthritis in patients without clinical cardiovascular disease. J Rheumatol 2011; 38:29-35. [PMID: 20952464 PMCID: PMC3014403 DOI: 10.3899/jrheum.100346] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE to examine whether patients with rheumatoid arthritis (RA) with no overt cardiovascular disease (CVD) have a higher prevalence of metabolic syndrome (MetS) than subjects without RA or CVD. We also examined whether RA disease characteristics are associated with the presence of MetS in RA patients without CVD. METHODS subjects from a population-based cohort of patients who fulfilled 1987 American College of Rheumatology criteria for RA between January 1, 1980, and December 31, 2007, were compared to non-RA subjects from the same population. All subjects with any history of CVD were excluded. Waist circumference, body mass index (BMI), and blood pressure were measured during the study visit. Data on CVD, lipids, and glucose measures were ascertained from medical records. MetS was defined using NCEP/ATP III criteria. Differences between the 2 cohorts were examined using logistic regression models adjusted for age and sex. RESULTS the study included 232 RA subjects without CVD and 1241 non-RA subjects without CVD. RA patients were significantly more likely to have increased waist circumference and elevated blood pressure than non-RA subjects, even though BMI was similar in both groups. Significantly more RA patients were classified as having MetS. In RA patients, MetS was associated with Health Assessment Questionnaire Disability Index, large-joint swelling, and uric acid levels, but not with C-reactive protein or RA therapies. CONCLUSION among subjects with no history of CVD, patients with RA are more likely to have MetS than non-RA subjects. MetS in patients with RA was associated with some measures of disease activity.
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Affiliation(s)
- Cynthia S. Crowson
- Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Elena Myasoedova
- Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - John M. Davis
- Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Eric L. Matteson
- Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Veronique L. Roger
- Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Terry M. Therneau
- Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Patrick Fitz-Gibbon
- Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Richard J. Rodeheffer
- Division of Cardiovascular Diseases, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Sherine E. Gabriel
- Department of Health Sciences Research, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
- Division of Rheumatology, Mayo Clinic, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Dao HH, Do QT, Sakamoto J. Increased frequency of metabolic syndrome among Vietnamese women with early rheumatoid arthritis: a cross-sectional study. Arthritis Res Ther 2010; 12:R218. [PMID: 21182767 PMCID: PMC3046531 DOI: 10.1186/ar3203] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 11/20/2010] [Accepted: 12/23/2010] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is associated with increased morbidity and mortality due to cardiovascular disease, and this occurs early in the disease process. The metabolic syndrome (MetS) may contribute to the excess cardiovascular burden observed in RA; however, little information is available regarding MetS in early RA. We aimed to identify the prevalence of MetS and to determine the potential factors associated with the presence of MetS in Vietnamese women with early RA. METHODS A total of 105 consecutive women with early RA (disease duration ≤3 years) and 105 age-matched healthy women were checked for MetS according to six MetS definitions (Joint Consensus, International Diabetes Federation, National Cholesterol Education Program 2004 and 2001, European Group for Study of Insulin Resistance, and World Health Organization). Multivariate logistic regression models were constructed to determine independent predictors of MetS in women with RA. RESULTS Prevalence of MetS varied from 16.2% to 40.9% according to the definitions used in women with RA, and was higher (P < 0.001) than in healthy controls (from 10.5% to 22.9%). Among individual components of MetS, differences between women with RA and controls were observed for hypertension (P < 0.001), low high density lipoprotein-cholesterol (HDL-C) levels (P < 0.001), and abdominal obesity (P = 0.019). After adjusting for age and physical activity, higher erythrocyte sedimentation rate (ESR) (odds ratios (OR) = 1.516, 95% confidence interval (CI): 1.073 to 3.195, P = 0.042), disease activity score (DAS28) (OR = 1.736, 95% CI: 1.293 to 2.786, P = 0.019), health assessment questionnaire (HAQ) score (OR = 1.583, 95% CI: 1.195 to 2.367, P = 0.035), and less methotrexate use (OR = 0.736, 95% CI: 0.547 to 0.962, P = 0.024) remained significant independent predictors of the presence of MetS in women with RA. CONCLUSIONS Women with early RA already had higher prevalence of MetS compared with healthy controls. Higher systemic inflammatory marker, disease activity and disability scores, and less methotrexate use were independent predictors associated with the presence of MetS in women with early RA. These findings suggest that physicians should screen for MetS in women with early RA to control its components and therefore reduce their risk of cardiovascular diseases.
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Affiliation(s)
- Hanh-Hung Dao
- Department of Young Leaders' Program in HealthCare Administration, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Nagoya 466-8550, Japan.
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Auranofin protects against anthrax lethal toxin-induced activation of the Nlrp1b inflammasome. Antimicrob Agents Chemother 2010; 55:1028-35. [PMID: 21149629 DOI: 10.1128/aac.00772-10] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Anthrax lethal toxin (LT) is the major virulence factor for Bacillus anthracis. The lethal factor (LF) component of this bipartite toxin is a protease which, when transported into the cellular cytoplasm, cleaves mitogen-activated protein kinase kinase (MEK) family proteins and induces rapid toxicity in mouse macrophages through activation of the Nlrp1b inflammasome. A high-throughput screen was performed to identify synergistic LT-inhibitory drug combinations from within a library of approved drugs and molecular probes. From this screen we discovered that auranofin, an organogold compound with anti-inflammatory activity, strongly inhibited LT-mediated toxicity in mouse macrophages. Auranofin did not inhibit toxin transport into cells or MEK cleavage but inhibited both LT-mediated caspase-1 activation and caspase-1 catalytic activity. Thus, auranofin inhibited LT-mediated toxicity by preventing activation of the Nlrp1b inflammasome and the downstream actions that occur in response to the toxin. Idebenone, an analog of coenzyme Q, synergized with auranofin to increase its protective effect. We found that idebenone functions as an inhibitor of voltage-gated potassium channels and thus likely mediates synergy through inhibition of the potassium fluxes which have been shown to be required for Nlrp1b inflammasome activation.
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da Silva BSP, Bonfá E, de Moraes JCB, Saad CGS, Ribeiro ACDM, Gonçalves CR, de Carvalho JF. Effects of anti-TNF therapy on glucose metabolism in patients with ankylosing spondylitis, psoriatic arthritis or juvenile idiopathic arthritis. Biologicals 2010; 38:567-9. [PMID: 20638299 DOI: 10.1016/j.biologicals.2010.05.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Revised: 05/07/2010] [Accepted: 05/07/2010] [Indexed: 11/27/2022] Open
Abstract
The objective of this study was to evaluate the influence of anti-tumor necrosis factor (anti-TNF) in juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS) or psoriatic arthritis (PsA). Sixty-two patients were investigated: 7 JIA; 37 AS; and 18 PsA. Caucasian race accounted for 79% and 29% were female. Mean age was 40.4 +/- 12.6 years. None of the patients had a history of diabetes, and none had used oral hypoglycemic agents or insulin. Treatment was with adalimumab, infliximab and etanercept. Glucose, inflammatory markers and prednisone dose were assessed at baseline, as well as after three and six months of treatment. The mean erythrocyte sedimentation rate was significantly lower at three months and six months than at baseline (13.7 +/- 18.0 and 18 +/- 22.5 vs. 27.9 +/- 23.4 mm; p = 0.001). At baseline, three months and six months, we found the following: mean C-reactive protein levels were comparable (22.1 +/- 22.7, 14.5 +/- 30.7 and 16.0 +/- 23.8 mg/L, respectively; p = 0.26); mean glucose levels remained unchanged (90.8 +/- 22.2 mg/dl, 89.5 +/- 14.6 mg/dl and 89.8 +/- 13.6 mg/dl, respectively; p = 0.91); and mean prednisone doses were low and stable (3.9 +/- 4.9 mg/day, 3.7 +/- 4.8 mg/day and 2.6 +/- 4.0 mg/day, respectively; p = 0.23). During the first six months of treatment, anti-TNF therapy does not seem to influence glucose metabolism in JIA, AS or PsA.
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Mathieu S, Motreff P, Soubrier M. Spondyloarthropathies: an independent cardiovascular risk factor? Joint Bone Spine 2010; 77:542-5. [PMID: 20646947 DOI: 10.1016/j.jbspin.2010.05.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2010] [Indexed: 12/16/2022]
Abstract
An increase in cardiovascular mortality and morbidity has been convincingly documented in rheumatoid arthritis. Data on spondyloarthropathies are more limited. Here, we discuss published studies indicating that patients with spondyloarthropathies are at increased risk for cardiovascular disease. The excess risk is probably multifactorial, being related both to chronic systemic inflammation and to high prevalences of conventional cardiovascular risk factors. Cardiovascular risk management in patients with spondyloarthropathies requires optimal control of disease activity combined with interventions targeting conventional cardiovascular risk factors.
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Affiliation(s)
- Sylvain Mathieu
- Service de rhumatologie, CHU Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand, France.
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43
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Soubrier M, Mathieu S, Bruckert E. Risque cardiovasculaire en rhumatologie : critères et scores. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.monrhu.2010.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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44
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Bellomio V, Spindler A, Lucero E, Berman A, Sueldo R, Berman H, Santana M, Molina MJ, Góngora V, Cassano G, Paira S, Saurit V, Retamozo S, Retamozo G, Alvarellos A, Caerio F, Alba P, Gotero M, Velozo EJ, Ceballos F, Soriano E, Catoggio L, García MA, Eimon A, Agüero S. Metabolic syndrome in Argentinean patients with systemic lupus erythematosus. Lupus 2010; 18:1019-25. [PMID: 19762406 DOI: 10.1177/0961203309105876] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The objective was to determine the prevalence of the metabolic syndrome (MS) in patients with systemic lupus erythematosus (SLE) in Argentina, to assess the factors associated to it, and to compare the results with a control group with non-inflammatory disorders. The study included 147 patients with SLE and 119 controls. MS was defined according to criteria by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) Scientific Statement. Demographic characteristics, Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/ACR Damage Index (SDI) were assessed as well as administration, maximum dose and cumulative dose of prednisone and hydroxychloroquine (HCQ). MS prevalence was 28.6% (CI 95%: 21.4-36.6) in patients with SLE and 16% in controls (P = 0.0019). Patients with SLE presented higher arterial hypertension frequency compared with controls (43 vs 25%, P = 0.007). When comparing lupus patients with MS (n = 41) and without MS (n = 106), no significant differences were observed regarding duration of the disease, SLEDAI or cumulative prednisone dose. Cumulative damage was associated independently with MS (OR 1.98; P = 0.021), whereas HCQ use was found to be protective (OR 0.13; P = 0.015). Patients with lupus presented higher MS prevalence than controls with non-inflammatory disorders, and occurrence of arterial hypertension was also higher. MS was associated with cumulative damage; the use of HCQ showed to be protective against presence of MS.
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Affiliation(s)
- V Bellomio
- Servicio de Reumatología, Hospital Angel Padilla, Universidad Nacional de Tucumán, Tucumán, Argentina
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45
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[Metabolic syndrome and aging]. Rev Esp Geriatr Gerontol 2009; 44:335-41. [PMID: 19913945 DOI: 10.1016/j.regg.2009.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2009] [Revised: 08/25/2009] [Accepted: 09/04/2009] [Indexed: 01/04/2023]
Abstract
In recent years, the current "obesity epidemic" and its correlate, metabolic syndrome, have been related not only to cardiovascular disease but also to the presence of multiple chronic diseases and even to the development of disability. Therefore, it has been hypothesized that this situation of risk and that of frailty, which has aroused such interest in geriatrics, could share common physiopathologic mechanisms. These mechanisms are reviewed in the present article.
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46
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Adiponectin and leptin serum concentrations in patients with rheumatoid arthritis. Rheumatol Int 2009; 30:731-7. [PMID: 19597733 DOI: 10.1007/s00296-009-1053-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2008] [Accepted: 06/28/2009] [Indexed: 01/08/2023]
Abstract
Adipose tissue is regarded as an active metabolic and endocrine organ producing adipokines. The purpose of the study was to evaluate adiponectin and leptin concentrations in rheumatoid arthritis (RA) patients (pts) in relation to disease duration and activity. The study group consisted of 80 RA pts. Serum adiponectin and leptin concentrations remained within normal ranges. Adiponectin concentration correlated positively both with the age and disease duration. Both adipokines levels correlated negatively with glomerular filtration rate. There were significant positive correlations between adipokines' concentrations and lipid profile components (between adiponectin and HDL-cholesterol, leptin and total cholesterol and LDL-cholesterol). In pts with long-standing RA, there was a negative correlation between adiponectin and numbers of tender, swollen joints and a positive relationship between leptin level and DAS28. The results confirm adipokines' involvement in the process of inflammation and atherosclerosis: protective and antiinflammatory adiponectin effect and proatherogenic and proinflammatory leptin function.
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47
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Pereira RMR, de Carvalho JF, Bonfá E. Metabolic syndrome in rheumatological diseases. Autoimmun Rev 2009; 8:415-9. [DOI: 10.1016/j.autrev.2009.01.001] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 01/07/2009] [Indexed: 11/27/2022]
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