Systemic Blockade of TNF-α does not Improve Insulin Resistance in Humans

I. Ferraz-Amaro; M. Arce-Franco; J. Muñiz; J. López-Fernández; V. Hernández-Hernández; A. Franco; J. Quevedo; J. Martínez-Martín; F. Díaz-González

doi:10.1055/s-0031-1287783

Hormone and Metabolic Research, Table of Contents

Horm Metab Res 2011; 43(11): 801-808
DOI: 10.1055/s-0031-1287783

Humans, Clinical

Systemic Blockade of TNF-α does not Improve Insulin Resistance in Humans

Authors

I. Ferraz-Amaro

¹Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
M. Arce-Franco

¹Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
J. Muñiz

²IMETISA, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
J. López-Fernández

³Servicio de Endocrinología, La Laguna, Santa Cruz de Tenerife, Spain

⁴Departamento de Medicina, Facultad de Medicina, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain
V. Hernández-Hernández

¹Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
A. Franco

⁵Laboratorio de Inmunología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
J. Quevedo

⁶Servicio de Reumatología, Hospital Universitario Dr. Negrin, Las Palmas de Gran Canarias, Spain
J. Martínez-Martín

⁷Servicio de Endocrinología, Hospital Universitario Dr. Negrin, Las Palmas de Gran Canarias, Spain
F. Díaz-González

¹Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain

⁴Departamento de Medicina, Facultad de Medicina, Universidad de La Laguna, La Laguna, Santa Cruz de Tenerife, Spain

Abstract

The purpose of this study was to determine whether long-term modulation of inflammatory activity by tumor necrosis factor (TNF)-α inhibitors has some influence on insulin resistance (IR). 16 active rheumatoid arthritis (RA) patients without CV risk factors treated with anti-TNF-α agents were included in this study. RA activity by disease activity score 28, IR by HOMA2-IR, body composition by impedance analysis, physical activity by accelerometry, abdominal fat distribution by magnetic resonance imaging, and serum level of key adipokines by ELISA were measured at baseline and during a 1-year follow-up period. Patient body mass index increased significantly (26.94±3.88 vs. 28.06±4.57 kg/m², p=0.02) after 1 year of treatment. Body composition, in terms of fat and fat-free mass, remained unchanged except for a significant elevation in body cell mass (25.50±4.60 vs. 26.60±3.17 kg, p=0.02). Basal levels of IR in the RA patients included in this study were significantly higher than healthy controls (1.6±0.8 vs. 1.11±0.56, p=0.011) but did not change during the follow-up. Nor did basal concentrations of adiponectin, visfatin, leptin, ghrelin, resistin, and apelin in response to anti-TNF-α treatment; only retinol-binding protein 4, showed a significant increase (51.7±32.7 vs. 64.9±28.4 μg/ml, p=0.03) at the end of the study. IR, adiposity distribution, and serum levels of most adipokines are not significantly affected by long-term inhibition of TNF-α in RA patients. Our data suggest that although systemic blockade of TNF-α exerts an anticachectic effect in RA patients, it does not seem to play a major role in IR.

Key words

insulin resistance - inflammation - anti-TNF-α compounds - rheumatoid arthritis

Full Text

References

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