THU0140 INSULIN RESISTANCE AND LIPID PROFILE IN RHEUMATOID ARTHRITIS PATIENTS WITHOUT DIABETES MELLITUS OR FASTING HYPERGLYCEMIA

Background Diabetes mellitus (DM) is known to be associated with proatherogenic lipid profile and cardiovascular complications. Insulin resistance (IR) is the major pathophysiological mechanism contributing to type II DM development. Established in general population correlation between IR and dyslipidemia sometimes even without DM, should nevertheless be confirmed in patients (pts) with rheumatoid arthritis (RA). Objectives To analyze IR rates and identify IR predictive lipid profile in RA patients without DM or hyperglycemia. Methods Totally 47 RA pts (41 women, 6 men, 56 [39; 62] years old) without established DM and with normal fasting glucose levels (<6,1 mmol/l) were enrolled in the study. Median disease duration was 6 [5;14] years. The majority of pts were IgM RF (83%) and anti-CCP (83%) seropositive, had low (40,4%) or moderate (42,6%) RA activity based on DAS28-ESR scores. RA pts were treated with glucocorticoids (51,1%), methotrexate (57,4%) or other disease-modifying antirheumatic drugs (23,4%), biological agents (17,0%) and statins (10,6%). IR was defined as Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index ≥2,77. Lipid profile included evaluation of the following parameters: serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides (TG). Additionally, non-HDL-C = TC - HDL-C and TG/HDL-C ratio were also evaluated. Results Median HOMA-IR levels were 1,7 [1,1;3,2]. HOMA-IR index correlates with age (r=0,3, p=0,04), body mass index (r=0,6, p<0,001), waist circumference (r=0,6, p<0,001), TC (r=0,3, p=0,02), non-HDL (r=0,3, p=0,03), TG concentrations (r=0,5, p<0,001) and TG/HDL-C ratio (r=0,4, p=0,006). IR was detected in 15 (31,9%) RA pts. RA pts with (group 1, n=15) or without IR (group 2, n=32) were comparable in terms of age, sex, disease duration and activity, therapy, and comorbidities including arterial hypertension, myocardial infarction + coronary revascularization. Hypertriglyceridemia (≥1,7mmol/l) was more often present in pts with IR compared to pts without IR (33,3% vs 6,3%, p=0,03).Table 1 Lipid profile in RA patient with and without IR Lipid parameters 1 groupIR (+)(n=15) 2 groupIR(-)(n=32) p TC, mmol/l 5,5 [4,8;6,5] 5,2 [4,3;5,8] 0,16 HDL-C, mmol/l 1,7 [1,3;1,9] 1,7 [1,6;2,1] 0,25 LDL-C, mmol/l 3,4 [2,5;4,2] 2,9 [2,1;3,5] 0,12 TG, mmol/l 1,3 [0,8;2,2] 0,9 [0,7;1,1] 0,007 Non-HDL, mmol/l 4,0 [2,9;4,9] 3,2 [2,6;3,8] 0,09 TG/HDL-C ratio 0,8 [0,5;1,3] 0,5 [0,4;0,7] 0,01Table 1 Lipid profile in RA patient with and without IR Lipid parameters 1 groupIR (+)(n=15) 2 groupIR(-)(n=32) p TC, mmol/l 5,5 [4,8;6,5] 5,2 [4,3;5,8] 0,16 HDL-C, mmol/l 1,7 [1,3;1,9] 1,7 [1,6;2,1] 0,25 LDL-C, mmol/l 3,4 [2,5;4,2] 2,9 [2,1;3,5] 0,12 TG, mmol/l 1,3 [0,8;2,2] 0,9 [0,7;1,1] 0,007 Non-HDL, mmol/l 4,0 [2,9;4,9] 3,2 [2,6;3,8] 0,09 TG/HDL-C ratio 0,8 [0,5;1,3] 0,5 [0,4;0,7] 0,01 Conclusion More than 30% of RA pts without DM and with normal serum fasting glucose concentration had IR. The IR was associated with increased TG levels and elevated TG/HDL-C ratio in RA pts. This proatherogenic lipid profile could be responsible for earlier development of cardiovascular complications. Disclosure of Interests None declared