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Article Summary
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Chung CP et al. - The pathogenesis of insulin resistance and its contribution to atherogenesis varies in different inflammatory settings. Methods- Hypothesis that decreased insulin sensitivity is differentially associated with mediators of inflammation was tested in SLE and RA
- Fasting insulin, glucose, and lipid levels, ESR, CRP, IL-6, TNF, and coronary artery calcification were measured in 103 SLE and 124 RA pts
- Insulin sensitivity was measured using the homeostasis model assessment (HOMA) index
Results- The HOMA value was higher in RA vs SLE pts
- CRP and ESR did not differ in RA and SLE pts
- BMI was correlated with the HOMA index in both RA and SLE independently of age, sex, race, and current use of corticosteroids
- In RA pts, the HOMA index was also positively correlated with IL-6, TNF, CRP, ESR, coronary calcification, and DAS-28 scores
- Associations adjusted for age, sex, race, BMI, and current use of corticosteroids remained significant
- In SLE pts, the HOMA index was also correlated with ESR and CRP but not with other variables
- The association between the ESR and the HOMA value in pts with SLE were significant
- Major contributing factors to the HOMA index were the BMI in SLE pts, and IL-6 and TNF levels in RA pts
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