RESUMEN
ABSTRACT Objective: Autoantibodies are evident in the early stages of rheumatoid arthritis (RA) and play important roles in diagnosis. The aim of this study was to investigate the diagnostic capability and extent of anti-RA 33 positivity and clinical characteristics in patients with RA. Methods: We included 67 RA patients and 20 healthy subjects in our study. Duration of symptoms, duration of disease, the extent of delay in diagnosis, episodes of clinical remission, and type and number of disease-modifying antirheumatic drugs (DMARDs) taken were noted. To evaluate quality of life, the Health Assessment Questionnaire (HAQ) Disability Index (consisting of 20 questions) was applied. Disease activity was evaluated with Disease Activity Score (DAS) 28. The laboratory assessments included erythrocyte sedimentation rate, C-reactive protein level and serologic assessments for rheumatoid factor, anti-cyclic citrullinated protein and anti-RA 33. Results: The mean disease duration was 14.56 months. A total of 38 (56.7%) patients were positive for anti-RA 33 antibodies. Twenty-four (63%) of patients positive for anti-RA 33 were clinically in remission. A negative correlation was evident between anti-RA 33 positivity and number of DMARDs taken and HAQ score (r = −0,766, p < 0.001; r = −0.737, p < 0.001). A positive correlation was evident between anti-RA 33 positivity and DAS 28 score (r = 0.287, p = 0.019). Conclusion: Anti-RA 33 antibodies have poor diagnostic capability in patients with RA. Anti-RA 33 antibodies may exert helpful effects determining prognosis in established RA patients.
RESUMEN
ABSTRACT Objective: To investigate obesity and insulin resistance and associated factors in patients with rheumatoid arthritis (RA). Methods: We included a cohort of patients with RA. In the clinical research, duration of disease, existence of clinical remission (disease activity index [DAS] 28 below 2.6) and amount of the relevant disease-modifying anti-rheumatic drugs were derived from clinical datum. Cumulative corticosteroid dose was calculated by duration of corticosteroid usage and ratio of physiologic dose. Insulin resistance was calculated with the homeostasis model of assessment of insulin resistance. Results: A total of 64 patients aged between 22 and 77 with RA were studied. Insulin resistance was detected in 34.4% (n = 22) of patients. There was a statistically significant correlation between body mass index and DAS28 scores (r = 0.469, p = 0.000). We found that the incidence of insulin resistance was lower in patients treated with methotrexate at least 1 year (p = 0.001). As long as we did not detect insulin resistance, none of the patients (n = 7) treated with tumour necrosis factor (TNF) blockers. Cumulative steroid dose, presence of obesity and DAS28 were the best predictors for insulin resistance according to multivariate linear regression analysis (R2c = 0.242, F = 6.39, p < 0.001). In this model R2c for cumulative steroid dose was 0.113 (F = 7.88 p < 0.007) and obesity was 0.147 (F = 10.67, p = 0.02). Conclusion: Obesity and long-standing corticosteroid usage were determinants of insulin resistance in patients with RA. Medications such as methotrexate, TNF blockers may help to reduce insulin resistance.