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Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis.

Publication ,  Journal Article
AbouAssi, H; Tune, KN; Gilmore, B; Bateman, LA; McDaniel, G; Muehlbauer, M; Huebner, JL; Hoenig, HM; Kraus, VB; St Clair, EW; Kraus, WE; Huffman, KM
Published in: J Rheumatol
October 2014

OBJECTIVE: In prior reports, individuals with rheumatoid arthritis (RA) exhibited increased insulin resistance. However, those studies were limited by either suboptimal assessment methods for insulin sensitivity or a failure to account for important determinants such as adiposity and lack of physical activity. Our objectives were to carefully assess, compare, and determine predictors of skeletal muscle insulin sensitivity in RA, accounting for adiposity and physical activity. METHODS: Thirty-nine individuals with established (seropositive or erosions) and treated RA and 39 controls matched for age, sex, race, body mass index, and physical activity underwent a frequently sampled intravenous glucose tolerance test to determine insulin sensitivity. Inflammation, body composition, and physical activity were assessed with systemic cytokine measurements, computed tomography scans, and accelerometry, respectively. Exclusions were diabetes, cardiovascular disease, medication changes within 3 months, and prednisone use over 5 mg/day. This investigation was powered to detect a clinically significant, moderate effect size for insulin sensitivity difference. RESULTS: Despite elevated systemic inflammation [interleukin (IL)-6, IL-18, tumor necrosis factor-α; p < 0.05 for all], persons with RA were not less insulin sensitive [SI geometric mean (SD): RA 4.0 (2.4) vs control 4.9 (2.1)*10(-5) min(-1)/(pmol/l); p = 0.39]. Except for visceral adiposity being slightly greater in controls (p = 0.03), there were no differences in body composition or physical activity. Lower insulin sensitivity was independently associated with increased abdominal and thigh adiposity, but not with cytokines, disease activity, duration, disability, or disease-modifying medication use. CONCLUSION: In established and treated RA, traditional risk factors, specifically excess adiposity, play more of a role in predicting skeletal muscle insulin sensitivity than do systemic inflammation or other disease-related factors.

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Published In

J Rheumatol

DOI

EISSN

1499-2752

Publication Date

October 2014

Volume

41

Issue

10

Start / End Page

1974 / 1979

Location

Canada

Related Subject Headings

  • Tumor Necrosis Factor-alpha
  • Muscle, Skeletal
  • Middle Aged
  • Male
  • Interleukin-6
  • Interleukin-18
  • Insulin Resistance
  • Humans
  • Glucose Tolerance Test
  • Female
 

Citation

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AbouAssi, H., Tune, K. N., Gilmore, B., Bateman, L. A., McDaniel, G., Muehlbauer, M., … Huffman, K. M. (2014). Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis. J Rheumatol, 41(10), 1974–1979. https://doi.org/10.3899/jrheum.140224
AbouAssi, Hiba, K Noelle Tune, Brian Gilmore, Lori A. Bateman, Gary McDaniel, Michael Muehlbauer, Janet L. Huebner, et al. “Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis.J Rheumatol 41, no. 10 (October 2014): 1974–79. https://doi.org/10.3899/jrheum.140224.
AbouAssi H, Tune KN, Gilmore B, Bateman LA, McDaniel G, Muehlbauer M, et al. Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis. J Rheumatol. 2014 Oct;41(10):1974–9.
AbouAssi, Hiba, et al. “Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis.J Rheumatol, vol. 41, no. 10, Oct. 2014, pp. 1974–79. Pubmed, doi:10.3899/jrheum.140224.
AbouAssi H, Tune KN, Gilmore B, Bateman LA, McDaniel G, Muehlbauer M, Huebner JL, Hoenig HM, Kraus VB, St Clair EW, Kraus WE, Huffman KM. Adipose depots, not disease-related factors, account for skeletal muscle insulin sensitivity in established and treated rheumatoid arthritis. J Rheumatol. 2014 Oct;41(10):1974–1979.

Published In

J Rheumatol

DOI

EISSN

1499-2752

Publication Date

October 2014

Volume

41

Issue

10

Start / End Page

1974 / 1979

Location

Canada

Related Subject Headings

  • Tumor Necrosis Factor-alpha
  • Muscle, Skeletal
  • Middle Aged
  • Male
  • Interleukin-6
  • Interleukin-18
  • Insulin Resistance
  • Humans
  • Glucose Tolerance Test
  • Female