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Prevalence of type 2 diabetes and impaired fasting glucose in patients affected by rheumatoid arthritis: Results from a cross-sectional study.

Abstract Although the better management of rheumatoid arthritis (RA) has significantly improved the long-term outcome of affected patients, a significant proportion of these may develop associated comorbidities including cardiometabolic complications. However, it must be pointed out that a comprehensive cardiometabolic evaluation is still poorly integrated into the management of RA patients, due to a limited awareness of the problem, a lack of appropriate clinical studies, and optimal strategies for cardiovascular (CV) risk reduction in RA. In addition, although several studies investigated the possible association between traditional CV risk factors and RA, conflicting results are still available.On this basis, we planned this cross-sectional study, aimed at investigating the prevalence of type 2 diabetes (T2D) and impaired fasting glucose (IFG) in RA patients compared with age- and gender- matched control individuals. Furthermore, we analyzed the role of both traditional and RA-related CV risk factors in predicting T2D and IFG.We observed an increased prevalence of T2D in RA patients when compared with age- and gender-matched controls. Regression analyses demonstrated that the presence of high blood pressure (HBP), a longer disease duration, and exposure to corticosteroids (CCS) were significantly associated with an increased likelihood of being classified as T2D. In addition, we observed an increased prevalence of IFG in RA patients when compared with age- and gender-matched controls. Regression analyses demonstrated that a higher body mass index (BMI), the presence of metabolic syndrome (MetS), higher levels of total cholesterol, the presence of radiographic damage, and higher serum levels of C-reactive protein (CRP) were significantly associated with an increased likelihood of presenting IFG.In this cross-sectional study, we observed an increased prevalence of T2D and IFG in an Italian cohort of RA patients when compared with age- and gender-matched control individuals. Interestingly, both RA-specific features, such as disease duration, CCS exposure, and radiographic damage, and traditional CV risk factors, such as HBP and MetS, were significantly associated with glucose metabolism abnormalities.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834907
OWN - NLM
STAT- In-Process
DA  - 20170823
LR  - 20170823
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Prevalence of type 2 diabetes and impaired fasting glucose in patients affected
      by rheumatoid arthritis: Results from a cross-sectional study.
PG  - e7896
LID - 10.1097/MD.0000000000007896 [doi]
AB  - Although the better management of rheumatoid arthritis (RA) has significantly
      improved the long-term outcome of affected patients, a significant proportion of 
      these may develop associated comorbidities including cardiometabolic
      complications. However, it must be pointed out that a comprehensive
      cardiometabolic evaluation is still poorly integrated into the management of RA
      patients, due to a limited awareness of the problem, a lack of appropriate
      clinical studies, and optimal strategies for cardiovascular (CV) risk reduction
      in RA. In addition, although several studies investigated the possible
      association between traditional CV risk factors and RA, conflicting results are
      still available.On this basis, we planned this cross-sectional study, aimed at
      investigating the prevalence of type 2 diabetes (T2D) and impaired fasting
      glucose (IFG) in RA patients compared with age- and gender- matched control
      individuals. Furthermore, we analyzed the role of both traditional and RA-related
      CV risk factors in predicting T2D and IFG.We observed an increased prevalence of 
      T2D in RA patients when compared with age- and gender-matched controls.
      Regression analyses demonstrated that the presence of high blood pressure (HBP), 
      a longer disease duration, and exposure to corticosteroids (CCS) were
      significantly associated with an increased likelihood of being classified as T2D.
      In addition, we observed an increased prevalence of IFG in RA patients when
      compared with age- and gender-matched controls. Regression analyses demonstrated 
      that a higher body mass index (BMI), the presence of metabolic syndrome (MetS),
      higher levels of total cholesterol, the presence of radiographic damage, and
      higher serum levels of C-reactive protein (CRP) were significantly associated
      with an increased likelihood of presenting IFG.In this cross-sectional study, we 
      observed an increased prevalence of T2D and IFG in an Italian cohort of RA
      patients when compared with age- and gender-matched control individuals.
      Interestingly, both RA-specific features, such as disease duration, CCS exposure,
      and radiographic damage, and traditional CV risk factors, such as HBP and MetS,
      were significantly associated with glucose metabolism abnormalities.
FAU - Ruscitti, Piero
AU  - Ruscitti P
AD  - aDivision of Rheumatology, Department of Biotechnological and Applied Clinical
      Science, University of L'Aquila, L'Aquila bDepartment of Health Sciences,
      University of Catanzaro "Magna Graecia", Catanzaro cDivision of Rheumatology,
      Department of Internal Medicine, University of Palermo, Palermo, Italy.
FAU - Ursini, Francesco
AU  - Ursini F
FAU - Cipriani, Paola
AU  - Cipriani P
FAU - Ciccia, Francesco
AU  - Ciccia F
FAU - Liakouli, Vasiliki
AU  - Liakouli V
FAU - Carubbi, Francesco
AU  - Carubbi F
FAU - Guggino, Giuliana
AU  - Guggino G
FAU - Berardicurti, Onorina
AU  - Berardicurti O
FAU - Grembiale, Rosadaniela
AU  - Grembiale R
FAU - Triolo, Giovanni
AU  - Triolo G
FAU - De Sarro, Giovambattista
AU  - De Sarro G
FAU - Giacomelli, Roberto
AU  - Giacomelli R
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/08/24 06:00
MHDA- 2017/08/24 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007896 [doi]
AID - 00005792-201708250-00044 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7896. doi: 10.1097/MD.0000000000007896.