Association of Rheumatoid Arthritis with Diabetic Comorbidity: Correlating Accelerated Insulin Resistance to Inflammatory Responses in Patients

Abstract

Amit K Verma,1,* Deepti Bhatt,1,* Yamini Goyal,1,* Kapil Dev,1 Mirza Masroor Ali Beg,2 Mohammed A Alsahli,3 Arshad Husain Rahmani3 1Department of Biotechnology, Jamia Millia Islamia, New Delhi, India; 2Department of Biochemistry, Maulana Azad Medical College, New Delhi, India; 3Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia*These authors contributed equally to this workCorrespondence: Amit K VermaDepartment of Biotechnology, Jamia Millia Islamia, 413, Medical Biotechnology Lab, Srinivasa Ramanujan Block, Mujeeb Bagh, New Delhi, 110025, IndiaEmail [email protected]: Over the past two decades, with advancement of medical research and technology, treatments of many diseases including chronic disorders like rheumatoid arthritis (RA) have been revolutionized. Treatment and management of RA has been refined by advances in understanding its pathologic mechanisms, the development of drugs which target them and its association with various other chronic comorbidities like diabetes. Diabetes prevalence is closely associated with RA since elevated insulin resistance have been observed with RA. It is also associated with inflammation caused due to pro-inflammatory cytokines like tumour necrosis factor α and interleukin 6. Inflammation encourages insulin resistance and also stimulates other factors like a high level of rheumatoid factor in the blood leading to positivity of rheumatoid factor in RA patients. The degree of RA inflammation also tends to influence the criticality of insulin resistance, which increases with high activity of RA and vice versa. Markers of glucose metabolism appear to be improved by DMARDs like methotrexate, hydroxychloroquine, interleukin 1 antagonists and TNF antagonist while glucocorticoids adversely affect glycemic control especially when administered chronically. The intent of the present review paper is to understand the association between RA, insulin resistance and diabetes; the degree to which both can influence the other along with the plausible impact of RA medications on diabetes and insulin resistance.Keywords: rheumatoid arthritis, diabetes, myocardial infarction, tumor necrosis factor α, interleukin 6

Keywords

• rheumatoid arthritis
• diabetes
• myocardial infarction
• tumor necrosis factor - α and interleukin 6.