Disease activity, cytokines, directly linked to diabetes risk in RA: Study

Medically Reviewed By : Dr. Kamal Kant Kohli

Published On 2021-01-18 12:30 GMT | Update On 2021-01-19 09:53 GMT

According to recent investigations, it has been observed that higher the disease activity and elevated levels of cytokines/chemokines, higher is the risk of incident DM in patients with RA.

The study is published in the Annals of Rheumatic Diseases.

Rheumatoid arthritis (RA) is associated with a higher risk of diabetes mellitus (DM). Hence, Joshua F Baker and colleagues from the Rheumatology Department, Corporal Michael J Crescenz VA Medical Center, Philadelphia, USA aimed to determine associations between inflammatory disease activity (including evaluation of specific cytokines and chemokines) and incident DM.

A total of 1866 patients with RA without prevalent DM were enrolled in the study. Participants were adults with physician-confirmed RA from Veteran's Affairs Rheumatoid Arthritis Registry.

Disease activity and clinical assessments occur longitudinally as part of clinical care. Thirty cytokines and chemokines were measured in banked serum obtained at the time of enrolment. Cytokine/chemokine values were log-adjusted and standardized (per SD).

Incident DM was defined based on validated algorithms using diagnostic codes and medications. Multivariable Cox proportional hazard models evaluated associations between clinical factors and incident DM. Independent associations between cytokines/chemokines and incident DM were assessed adjusting for age, sex, race, smoking, body mass index (BMI) and medication use at baseline.

The following findings were highlighted-

a. Out of the total sample, there were 130 incident cases over 9223 person-years of follow-up.

b. High Disease Activity Score (DAS28)-C reactive protein (CRP), obese BMI, older age and male sex were associated with greater risk for incident DM while current smoking and methotrexate use were protective.

c. Patients using methotrexate were at lower risk.

d. Several cytokines/chemokines evaluated were independently associated (per 1 SD) with DM incidence including interleukin(IL)-1, IL-6 and select macrophage-derived cytokines/chemokines (HR range 1.11–1.26).

Hence, it was concluded that "higher disease activity and elevated levels of cytokines/chemokines are associated with a higher risk of incident DM in patients with RA. Future study may help to determine if targeted treatments in at-risk individuals could prevent the development of DM."

Article Source : Annals of Rheumatic Diseases

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Dr. Nandita Mohan

Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

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