Impaired glucose handling in active rheumatoid arthritis: relationship to peripheral insulin resistance.

摘要: Glucose metabolism was studied after an intravenous glucose loading in normal-weighted, previously untreated patients (n = 14) with active rheumatoid arthritis (RA). The displayed enhanced insulin response and impaired handling compared healthy controls (P < .001). sensitivity, measured as the utilization rate during steady state of euglycemia (M) significantly decreased .01) among to (5.5 ± 1.9 mg/kg BW/min [mean SD] 7.2 1.2, respectively). corresponding values for metabolic clearance (MCR) were 5.8 0.6 mL/kg 8.2 0.4, respectively .01). In patient group k value correlated peripheral sensitivity .01), which, turn, inversely related acute phase reaction .05). During 1 week potent anti-inflammatory treatment corticosteroids (prednisolone 20 mg daily) improved P .001), tended improve increased .001) loading. Five who had a remission their disease on sulphasalazine antirheumatic therapy reexamined. A normalization inflammatory activity well achieved. data obtained indicate that RA is resistance. linkage between indices might reflect special consequence inflammation, but influence nonspecific manifestations, ie, malnutrition, inactivity, myopenia, has be considered. Furthermore, measurements plasma C-peptide concentrations calculation molar ratio suggested hyperinsulinemia partly due hepatic extraction insulin.