Changes of blood glucose and lipid metabolism in patients of type 2 diabetes concomitant with rheumatoid arthritis

Pan Lili; Sun Xiaolin; Wang Tian

doi:10.3760/cma.j.issn.1673-4777.2014.02.016

Abstract：Objective To investigate the characteristics of blood glucose and lipid metabolism in patients of type 2 diabetes mellitus (T2DM)concomitant with rheumatoid arthritis (RA).Methods Totally 73 patients of T2DM concomitant with RA were enrolled; T2DM patients without RA were as controls.Body mass index (BMI),systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients of T2DM with and without RA were measured.Serum triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),fasting blood glucose (FBG),2 h postprandial blood glucose (PBG),C-reactive protein (CRP),glycated albumin (GA),glycosylated hemoglobin (HbA1 c) and erythrocyte sedimentation rate (ESR) were detected; the differences of each index between 2 groups were compared; patients of T2DM concomitant with RA were divided into abnormal ESR and normal ESR groups.Results Levels of serum TC were lower in T2DM combined with RA patients (4.3 ± 1.0) mmol/L than those of controls (4.7 ± 0.9) mmol/L(P ＜0.05) ; TC / HDL-C (4.0 ± 1.0) were lower in T2DM concomitant with RA patients (4.5 ± 1.4) (P ＜ 0.05) ;LDL-C levels in patients of T2DM concomitant with RA (2.6 ± 0.7) mmol/L were significantly lower (3.0 ±0.4) mmol/L (P ＜ 0.01) ; serum CRP and ESR were significantly higher in patients of T2DM concomitant with RA than those in control group 14.54 (1.62,17.95) mg/L vs 2.13 (0.83,4.77) mg/L and (38 ± 22) vs (16 ± 11) mm/1 h,respectively (all P ＜ 0.01) ; BMI,SBP and DBP in patients of T2DM with and without RA did not show any differences; TG,FBG,PBG,GA and HbAlc did not show significant differences between 2 groups.In patients of T2DM concomitant with RA,TC/HDL-C were significantly higher in abnormal ESR group (4.2 ± 1.0)mmol/L (P ＜ 0.05) ; GA levels were higher in abnormal ESR group(28 ± 11)％ than those in normal ESR group (18 ± 5) ％ (P ＜ 0.05) ; CRP level was significantly higher in abnormal ESR group 15.52 (6.47,28.67) mg/L than that in normal ESR group 3.14 (1.17,6.18)nmg/L(P ＜ 0.01) ; FBG,PBG and HbA1c did not show any differences between 2 groups.Conclusions The levels of lipids metabolism in patients of T2DM concomitant with RA are significantly lower than those in patients of T2DM without RA ; the lipids metabolism disorders may be caused by RA itself.Elevated activity of RA disease may increase the level of inflammatory response and disorders of blood glucose and lipids metabolism,which may further aggravate the risk of cardiovascular disease in patients with T2DM.