More RA Disease Activity Linked to Higher Diabetes Risk

PHILADELPHIA — Considering that rheumatoid arthritis is associated with a higher risk of diabetes mellitus, a new study sought to determine associations between inflammatory disease activity and incident DM.

Corporal Michael J Crescenz VAMC-led researchers evaluated specific cytokines and chemokines to help determine that. Colleagues from the VA Nebraska-Western Iowa Health Care System in Omaha and the VA Salt Lake City Health Care System also participated in the study.

According to the report in the Annals of the Rheumatic Diseases, participants were adults with physician-confirmed RA from Veterans Affairs Rheumatoid Arthritis Registry. Researchers measured 30 cytokines and chemokines in banked serum obtained at the time of enrollment. While 1,866 patients with RA did not have prevalent DM at enrollment, 130 incident cases occurred over 9,223 person-years of follow-up.¹

The study determined that High Disease Activity Score (DAS28)-C reactive protein (CRP), obese BMI, older age and male sex were all associated with greater risk for incident DM. On the other hand, current smoking and methotrexate use were found to be protective, with patients using methotrexate at lower risk.

In addition, several cytokines/chemokines evaluated were determined to be independently associated (per 1 SD) with DM incidence including interleukin(IL)-1, IL-6 and select macrophage-derived cytokines/chemokines (HR range 1.11-1.26). The associations were independent of the DAS28-CRP, according to the authors.

“Higher disease activity and elevated levels of cytokines/chemokines are associated with a higher risk of incident DM in patients with RA,” the researchers wrote. “Future study may help to determine if targeted treatments in at-risk individuals could prevent the development of DM.”

1. Baker JF, England BR, George M, Cannon G, et. Al. Disease activity, cytokines, chemokines and the risk of incident diabetes in rheumatoid arthritis. Ann Rheum Dis. 2021 Jan 4:annrheumdis-2020-219140. doi: 10.1136/annrheumdis-2020-219140. Epub ahead of print. PMID: 33397733.