| Diabetes mellitus and insulin resistance in patients with rheumatoid arthritis: Risk reduction in a chronic inflammatory disease. | |
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MedLine Citation:
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PMID: 21452264 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: To perform a systematic literature review of the potential association among molecular markers of inflammation, alterations in body composition, and insulin resistance (IR), a precursor to type 2 diabetes mellitus (DM), in rheumatoid arthritis (RA) patients. To determine the impact of tumor necrosis factor α (TNFα) as a pivotal proinflammatory cytokine in the pathophysiology of type 2 DM and RA, and the effect of antirheumatic drugs on glycemic control. METHODS: We performed a search of PubMed to identify articles on IR and body habitus in patients with RA. RESULTS: Patients with RA had characteristics placing them at high risk for IR and type 2 DM. The incidence and prevalence of type 2 DM in RA was not clearly increased compared with the general population; however, studies suggested that patients with RA are likely to have IR and have increased risk of cardiovascular disease (CVD). The prevalence of type 2 DM and IR could be estimated from reports of risk factors for CVD in RA patients. The TNFα antagonists provided rapid and effective control of RA-related inflammation. Evidence indicated that extended use of TNFα antagonists in RA may provide the additional benefit of improving insulin sensitivity. These treatment-related changes may contribute to an overall reduction in the risk of type 2 DM and CVD in RA patients. CONCLUSION: Controlling inflammation may improve insulin sensitivity and subsequently reduce the risk of developing type 2 DM in RA patients. This may also reduce the risk of CVD in this high-risk group. Future studies are required to elucidate the relationships between inflammation, body composition, IR, TNFα antagonist use, and the risk of developing type 2 DM in RA patients. |
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Authors:
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Mary Chester Wasko; Jonathan Kay; Elizabeth C Hsia; Mahboob U Rahman |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Arthritis care & research Volume: 63 ISSN: 2151-4658 ISO Abbreviation: Arthritis Care Res (Hoboken) Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101518086 Medline TA: Arthritis Care Res (Hoboken) Country: United States |
Other Details:
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Languages: eng Pagination: 512-21 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 by the American College of Rheumatology. |
Affiliation:
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University of Pittsburgh, Pittsburgh, Pennsylvania. wasko@pitt.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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