Top

Published in:

01-02-2014 | Original Article

Ankylosing spondylitis and other inflammatory spondyloarthritis increase the risk of developing type 2 diabetes in an Asian population

Authors: Hsin-Hung Chen, Su-Yin Yeh, Hue-Yong Chen, Cheng-Li Lin, Fung-Chang Sung, Chia-Hung Kao

Published in: Rheumatology International | Issue 2/2014

Abstract

This study evaluated whether people with ankylosing spondylitis (AS) and spondyloarthritis are at higher risk of type 2 diabetes mellitus (T2DM). We used a sub-dataset of the National Health Insurance Research Database from 1996 to 2010 to established a AS cohort consisting new patients with AS or spondyloarthritis (N = 7,778) and a non-AS cohort without the diseases (N = 31,112). Incidences of T2DM in the two cohorts, hazard ratios (HRs) of risk of T2DM in association with AS, and cumulative probability of having T2DM were estimated by the end of 2010. The incidence of T2DM was 1.17-fold higher in the AS cohort than in the non-AS cohort (13.5 vs. 11.5, per 1,000 person-years), with an adjusted HR of 1.16 (95 % CI = 1.05–1.29). The T2DM incidence was higher for women than for men; while the Cox model measured sex-specific adjusted HR of T2DM was higher for men than for women. The incidence rate of T2DM increased with age in both cohorts, while the age-specific measures showed that the adjusted HR of T2DM was higher in young AS patients (≤50 years of age) than older ones, compared to their peers of non-AS group. The plot of Kaplan–Meier analysis showed that the overall probability of having T2DM was 2 % higher in the AS cohort than in the non-AS cohort (log-rank test: p < 0.0001). Patients with AS and spondyloarthritis have an increased risk of developing T2DM.

Ng SC, Liao Z, Yu DT, Chan ES, Zhao L, Gu J (2007) Epidemiology of spondyloarthritis in the People’s Republic of China: review of the literature and commentary. Semin Arthritis Rheum 37:39–47PubMedCrossRef

Akkoc N, Khan MA (2006) Epidemiology of ankylosing spondylitis and related spondyloarthropathies. In: Weisman MHRJ, van der Heijde D (eds) Ankylosing spondylitis and the spondyloarthropathies: a companion to rheumatology. Mosby-Elsevier, London, pp 117–131

Radford EP, Doll R, Smith PG (1977) Mortality among patients with ankylosing spondylitis not given X-ray therapy. N Engl J Med 297:572–576PubMedCrossRef

Lehtinen K (1993) Mortality and causes of death in 398 patients admitted to hospital with ankylosing spondylitis. Ann Rheum Dis 52:174–176PubMedCrossRef

Mathieu S, Gossec L, Dougados M, Soubrier M (2011) Cardiovascular profile in ankylosing spondylitis: a systematic review and meta-analysis. Arthritis Care Res (Hoboken) 63:557–563CrossRef

Goodson NJ, Wiles NJ, Lunt M, Barrett EM, Silman AJ, Symmons DP (2002) Mortality in early inflammatory polyarthritis: cardiovascular mortality is increased in seropositive patients. Arthritis Rheum 46:2010–2019PubMedCrossRef

Han C, Robinson DW Jr, Hackett MV, Paramore LC, Fraeman KH, Bala MV (2006) Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 33:2167–2172PubMed

Peters MJ, van der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT (2004) Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spondylitis and psoriatic arthritis. Semin Arthritis Rheum 34:585–592PubMedCrossRef

Haffner SM (1999) Epidemiology of insulin resistance and its relation to coronary artery disease. Am J Cardiol 84:11J–14JPubMedCrossRef

10.

Svenson KL, Lundqvist G, Wide L, Hällgren R (1987) Impaired glucose handling in active rheumatoid arthritis: relationship to the secretion of insulin and counter-regulatory hormones. Metabolism 36:940–943PubMedCrossRef

11.

Svenson KL, Pollare T, Lithell H, Hällgren R (1988) Impaired glucose handling in active rheumatoid arthritis: relationship to peripheral insulin resistance. Metabolism 37:125–130PubMedCrossRef

12.

Ritchie LD, Ganapathy S, Woodward-Lopez G, Gerstein DE, Fleming SE (2003) Prevention of type 2 diabetes in youth: etiology, promising interventions and recommendations. Pediatr Diabetes 4:174–209PubMedCrossRef

13.

Freeman JS (2010) A physiologic and pharmacological basis for implementation of incretin hormones in the treatment of type 2 diabetes mellitus. Mayo Clin Proc 85:S5–S14PubMedCrossRef

14.

Brophy S, Cooksey R, Atkinson M, Zhou SM, Husain MJ, Macey S et al (2012) No increased rate of acute myocardial infarction or stroke among patients with ankylosing spondylitis-a retrospective cohort study using routine data. Semin Arthritis Rheum 42:140–145PubMedCrossRef

15.

Cheng TM (2009) Taiwan’s National Health Insurance system: high value for the dollar. In: Okma KGH, Crivelli L (eds) Six countries, six reform models: the health reform experience of Israel, the Netherlands, New Zealand, Singapore, Switzerland and Taiwan. World Scientific, New Jersey, pp 71–204

16.

Jiang YD, Chang CH, Tai TY, Chen JF, Chuang LM (2012) Incidence and prevalence rates of diabetes mellitus in Taiwan: analysis of the 2000–2009 Nationwide Health Insurance database. J Formos Med Assoc 111:599–604PubMedCrossRef

17.

Ford ES (1999) Body mass index, diabetes, and C-reactive protein among U.S. adults. Diabetes Care 22:1971–1977PubMedCrossRef

18.

McMillan DE (1989) Increased levels of acute-phase serum proteins in diabetes. Metabolism 38:1042–1046PubMedCrossRef

19.

Libby P, Ridker PM, Maseri A (2002) Inflammation and atherosclerosis. Circulation 105:1135–1143PubMedCrossRef

20.

Hotamisligil GS, Shargill NS, Spiegelman BM (1993) Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science 259:87–91PubMedCrossRef

21.

Gimeno RE, Klaman LD (2005) Adipose tissue as an active endocrine organ: recent advances. Curr Opin Pharmacol 5:122–128PubMedCrossRef

22.

Hotamisligil GS, Spiegelman BM (1994) Tumor necrosis factor alpha: a key component of the obesity-diabetes link. Diabetes 43:1271–1278PubMedCrossRef

23.

Hotamisligil GS, Murray DL, Choy LN, Spiegelman BM (1994) Tumor necrosis factor alpha inhibits signaling from the insulin receptor. Proc Natl Acad Sci USA 91:4854–4858PubMedCrossRef

24.

Brewerton DA, Hart FD, Nicholls A, Caffrey M, James DC, Sturrock RD (1973) Ankylosing spondylitis and HL-A 27. Lancet 1:904–907PubMedCrossRef

25.

Schlosstein L, Terasaki PI, Bluestone R, Pearson CM (1973) High association of an HL-A antigen, W27, with ankylosing spondylitis. N Engl J Med 288:704–706PubMedCrossRef

26.

Platz P, Jakobsen BK, Morling N, Ryder LP, Svejgaard A, Thomsen M, Christy M, Kromann H, Benn J, Nerup J, Green A, Hauge M (1981) HLA-D and -DR antigens in genetic analysis of insulin dependent diabetes mellitus. Diabetologia 21:108–115

27.

Reitnauer PJ, Roseman JM, Barger BO, Murphy CC, Kirk KA, Acton RT (1981) HLA associations with insulin-dependent diabetes mellitus in a sample of the American Black population. Tissue Antigens 17:286–293PubMedCrossRef

28.

Pittman WB, Acton RT, Barger BO, Bell DS, Go RC, Murphy CC et al (1982) HLA-A, -B, and -DR associations in type I diabetes mellitus with onset after age forty. Diabetes 31:122–125PubMedCrossRef

29.

Acton RT, Hodge TW, McDaniel DO, Reveille JD, Napier-Littrell M, Barger BO (1985) HLA restriction fragment length polymorphisms associated with insulin-dependent diabetes mellitus and the seronegative spondyloarthropathies. Biosci Rep 5:815–829PubMedCrossRef

30.

Sattar MA, Al-Sughyer AA, Siboo R (1988) Coexistence of rheumatoid arthritis, ankylosing spondylitis and dermatomyositis in a patient with diabetes mellitus and the associated linked HLA antigens. Br J Rheumatol 27:146–149PubMedCrossRef

31.

Clore JN, Thurby-Hay L (2009) Glucocorticoid-induced hyperglycemia. Endocr Pract 15:469–474PubMedCrossRef

32.

Mamdani M, Juurlink DN, Lee DS, Rochon PA, Kopp A, Naglie G et al (2004) Cyclo-oxygenase-2 inhibitors versus non-selective non-steroidal anti-inflammatory drugs and congestive heart failure outcomes in elderly patients: a population-based cohort study. Lancet 363:1751–1756PubMedCrossRef

33.

White WB, Kent J, Taylor A, Verburg KM, Lefkowith JB, Whelton A (2002) Effects of celecoxib on ambulatory blood pressure in hypertensive patients on ACE inhibitors. Hypertension 39:929–934PubMedCrossRef

34.

Matthaei S, Stumvoll M, Kellerer M, Häring HU (2000) Pathophysiology and pharmacological treatment of insulin resistance. Endocr Rev 21:585–618PubMed

35.

da Silva BS, Bonfá E, de Moraes JC, Saad CG, Ribeiro AC, Gonçalves CR et al (2010) Effects of anti-TNF therapy on glucose metabolism in patients with ankylosing spondylitis, psoriatic arthritis or juvenile idiopathic arthritis. Biologicals 38:567–569PubMedCrossRef

36.

Feldtkeller E, Khan MA, van der Heijde D, van der Linden S, Braun J (2003) Age at disease onset and diagnosis delay in HLA-B27 negative vs. positive patients with ankylosing spondylitis. Rheumatol Int 23:61–66PubMed

37.

Bakland G, Nossent HC, Gran JT (2005) Incidence and prevalence of ankylosing spondylitis in Northern Norway. Arthritis Rheum 53:850–855PubMedCrossRef

Title: Ankylosing spondylitis and other inflammatory spondyloarthritis increase the risk of developing type 2 diabetes in an Asian population
Authors: Hsin-Hung Chen
Su-Yin Yeh
Hue-Yong Chen
Cheng-Li Lin
Fung-Chang Sung
Chia-Hung Kao
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: Rheumatology International / Issue 2/2014
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-013-2927-5

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 2/2014

Is lecturing in Rheumatology Satellite Symposia a male attribute?

Comment on: Oxidative stress in erythrocytes from patients with rheumatoid arthritis

A possible genetic association with chronic fatigue in primary Sjögren’s syndrome: a candidate gene study

Standards of care for patients with spondyloarthritis

Comment on Song et al.: associations between the major histocompatibility complex class I chain-related gene A transmembrane (MICA-TM) polymorphism and susceptibility to psoriasis and psoriatic arthritis: a meta-analysis

Could the complement component C4 or its fragment C4d be a marker of the more severe conditions in patients with primary Sjögren’s syndrome?

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials