成人皮肌炎患者胰岛素抵抗增加

D. S. Oliveira, Marilda Silva Guimarães, S. Shinjo
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引用次数: 5

摘要

目的:评估糖皮质激素naïve皮肌炎患者的胰岛素血症,并利用胰岛素抵抗稳态模型评估(HOMA2-IR)评估胰岛素抵抗。方法:本横断面研究包括25例皮肌炎,非糖尿病糖皮质激素naïve患者。对照组由50名年龄、性别、种族、体重和身高相匹配的志愿者组成。根据基线胰岛素和血糖数据计算HOMA2IR指数。采用国际肌炎评估与临床研究小组(IMACS)参数评估疾病状态。结果:患者平均年龄43.5岁,以女性为主。根据IMACS参数,患者疾病活动度低。皮肌炎组的体重指数和腰围均高于对照组。皮肌炎患者的胰岛素水平和HOMA2-IR也较高。单独分析皮肌炎时,HOMA2-IR指数与体重、体质指数、腰围呈正相关,与疾病状态参数无关。结论:皮肌炎患者的基础胰岛素血症、胰岛素抵抗、体重指数和腰围值较高。此外,HOMA2-IR与这些人体测量参数适度相关。这些代谢异常与代谢综合征的发展有关,代谢综合征是皮肌炎的主要合并症之一。
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Insulin resistance is increased in adult patients with dermatomyositis
OBJECTIVE: To evaluate insulinemia in glucocorticoid naïve patients with dermatomyositis and to evaluate insulin resistance using the homeostatic model assessment of insulin resistance (HOMA2-IR). METHODS: This cross-sectional study included 25 dermatomyositis, non-diabetic glucocorticoid naïve patients. The control group consisted of 50 volunteers matched for age, gender, ethnicity, weight and height. The HOMA2IR index was calculated from baseline insulin and glucose data. The International Myositis Assessment & Clinical Studies Group (IMACS) parameters were used to evaluate disease status. RESULTS: Mean age of the patients was 43.5 years and these were predominantly females. Patients had low disease activity according to IMACS parameters. Higher body mass index and waist circumference were observed in the dermatomyositis group compared to the control group. Insulin level and HOMA2-IR were also higher in patients with dermatomyositis. Moreover, analyzing dermatomyositis alone, the HOMA2-IR index correlated positively with weight, body mass index and waist circumference and was independent on disease status parameters. CONCLUSIONS: Patients with dermatomyositis had higher values for basal insulinemia, insulin resistance, body mass index and waist circumference. Moreover, HOMA2-IR moderately correlated with these anthropometric parameters. These metabolic abnormalities are related to the development of metabolic syndrome, one of the main comorbidities observed in dermatomyositis.
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