Impact of TNF inhibition on insulin resistance and lipids levels in patients with rheumatoid arthritis
Abstract
Patients with rheumatoid arthritis (RA) have increased cardiovascular mortality. TNF-alpha is a critical mediator of inflammation and metabolic response in patients with RA. Increased insulin resistance and dyslipidemia were known risk factors in patients with active RA, however, the regulation of these metabolic parameters by TNF-alpha is poorly understood. Neutralization of TNF-alpha with infliximab offers a unique opportunity to study TNF-alpha-mediated regulation of these metabolic parameters in RA. The aim of the study was to assess the in vivo TNF-alpha-mediated regulation of insulin resistance and lipids levels in RA. Nineteen patients with active RA treated with infliximab were prospectively followed for 14 weeks. Plasma lipids levels and insulin resistance were measured at baseline, 6 and 14 weeks after infliximab treatment. At week 14, the disease activity (DAS-28 score) improved significantly (p < 0.000), with a significant reduction in both C-reactive protein (p = 0.007) and erythrocyte sedimentation rate (p = 0.006) levels. The body weight did not change during the study period. After infliximab treatment, insulin resistance improved as reflected by the significant reduction in the Homeostasis Model Assessment Index. Total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and apolipoprotein B (apoB) levels all increased significantly from baseline. Nonetheless, the atherogenic index, LDL-cholesterol/HDL-cholesterol ratio, and the LDL/apoB ratio remained unchanged. Infliximab improves insulin sensitivity and alters lipid profile in patients with active RA.
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Circulating advanced glycation end products accumulate when renal function is impaired.
“In addition, circulating AGE accumulate when renal function is impaired (456 -459) .”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [456]
In diabetic subjects with and without nephropathy given a single meal of egg-white cooked with or without fructose, there was a significant correlation between dietary advanced glycation end product content and serum advanced glycation end product levels.
“There was a significant correlation between dietary AGE content and serum AGE levels.”
From Dietary factors and low-grade inflammation in relation to overweight and obesity (2011) · cites this paper as [456]
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- Authors
- Tam, L.-S., Tomlinson, B., Chu, T. T., Li, T. K., & Li, E. K.
- Affiliations
- Chinese University of Hong Kong (HK)
- Corresponding author
- Tam, Lai-Shan
- Venue
- Clinical Rheumatology
- Published
- 2007-01-20
- Volume
- 26
- Issue
- 9
- Pages
- 1495-1498
- ISSN
- 0770-3198 (ISSN-L)
- 1434-9949
- OpenAlex
- W2170973130
- Cited by
- 197
- References
- 19
- Citations by year
- 2025: 1 · 2023: 5 · 2022: 2 · 2021: 8 · 2020: 7 · 2019: 7 · 2018: 10 · 2017: 10 · 2016: 15 · 2015: 13 · 2014: 16 · 2013: 16 · 2012: 20
- FWCI
- 11.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Rheumatology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- rheumatoid arthritis, anti-TNF therapy, infliximab, insulin resistance, dyslipidemia, lipid profile, cardiovascular risk, atherogenic index, apolipoprotein B, HDL cholesterol, LDL cholesterol, triglycerides, C-reactive protein, disease activity
- MeSH terms
- Infliximab, Adult, Aged, Antibodies, Monoclonal, Arthritis, Rheumatoid, Female, Humans, Insulin Resistance, Lipoproteins, Middle Aged, Prospective Studies, Tumor Necrosis Factor-alpha, Dyslipidemias
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