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Background <p>Rheumatoid arthritis (RA) is a chronic inflammatory disorder that affects the joints and is associated with increased cardiovascular risk and systemic inflammation. Increased cardiovascular risk and atherosclerosis are associated with insulin resistance (IR), which is defined as a reduction in cellular responsiveness to insulin.</p> <p>The relationship between IR, disease activity, and subclinical atherosclerosis in RA remains inadequately defined, despite the accumulation of more data. This study evaluated the association between insulin resistance, disease activity, and subclinical atherosclerosis in patients with RA.</p> Methods <p>Eighty patients diagnosed with RA participated in this cross-sectional study. To evaluate disease activity, the Disease Activity Score-28 (DAS-28) was used. Functional status was evaluated using the Health Assessment Questionnaire Disability Index (HAQ-DI), and pain severity was quantified using the Visual Analog Scale for Pain (VAS-pain). Insulin resistance was evaluated using the Homeostatic Model Assessment for IR (HOMA-IR). Carotid intima-media thickness (CIMT) was evaluated through ultrasonography. Statistical analysis included Spearman’s correlation and multiple linear regression analysis.</p> Results <p>HOMA-IR showed significant positive correlations with anti-cyclic citrullinated peptide antibodies, body mass index, C-reactive protein, DAS-28, erythrocyte sedimentation rate(ESR), HAQ-DI, lipid profile parameters ( total cholesterol, low-density lipoprotein, and triglycerides), and VAS-pain, whereas a negative correlation was noted with high-density lipoprotein. Significant positive associations were identified between HOMA-IR and CIMT. Multiple linear regression analysis identified DAS-28 and anti-CCP as independent predictors of IR.</p> Conclusion <p>IR, assessed by HOMA-IR, was significantly associated with RA disease activity, systemic inflammation, dyslipidemia, and subclinical atherosclerosis. DAS-28 and anti-CCP antibodies were identified as independent predictors of HOMA-IR. These findings suggest a potential role of insulin resistance in cardiovascular risk among RA patients.</p>

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Association of insulin resistance with progression of atherosclerosis in rheumatoid arthritis patients and its relation to disease activity

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月28日

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  • Shireen A. Ragab,
  • Waleed A. Salah EL-Deen,
  • Noha H. Ibrahim,
  • Dina S. Abdelomtaleb,
  • Enas M. Sweed,
  • Noha M. Abdelnaser

摘要

Background

Rheumatoid arthritis (RA) is a chronic inflammatory disorder that affects the joints and is associated with increased cardiovascular risk and systemic inflammation. Increased cardiovascular risk and atherosclerosis are associated with insulin resistance (IR), which is defined as a reduction in cellular responsiveness to insulin.

The relationship between IR, disease activity, and subclinical atherosclerosis in RA remains inadequately defined, despite the accumulation of more data. This study evaluated the association between insulin resistance, disease activity, and subclinical atherosclerosis in patients with RA.

Methods

Eighty patients diagnosed with RA participated in this cross-sectional study. To evaluate disease activity, the Disease Activity Score-28 (DAS-28) was used. Functional status was evaluated using the Health Assessment Questionnaire Disability Index (HAQ-DI), and pain severity was quantified using the Visual Analog Scale for Pain (VAS-pain). Insulin resistance was evaluated using the Homeostatic Model Assessment for IR (HOMA-IR). Carotid intima-media thickness (CIMT) was evaluated through ultrasonography. Statistical analysis included Spearman’s correlation and multiple linear regression analysis.

Results

HOMA-IR showed significant positive correlations with anti-cyclic citrullinated peptide antibodies, body mass index, C-reactive protein, DAS-28, erythrocyte sedimentation rate(ESR), HAQ-DI, lipid profile parameters ( total cholesterol, low-density lipoprotein, and triglycerides), and VAS-pain, whereas a negative correlation was noted with high-density lipoprotein. Significant positive associations were identified between HOMA-IR and CIMT. Multiple linear regression analysis identified DAS-28 and anti-CCP as independent predictors of IR.

Conclusion

IR, assessed by HOMA-IR, was significantly associated with RA disease activity, systemic inflammation, dyslipidemia, and subclinical atherosclerosis. DAS-28 and anti-CCP antibodies were identified as independent predictors of HOMA-IR. These findings suggest a potential role of insulin resistance in cardiovascular risk among RA patients.