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Multicenter Study
. 2010 Dec;69(12):2114-7.
doi: 10.1136/ard.2009.125476. Epub 2010 Jun 28.

Risk of diabetes among patients with rheumatoid arthritis, psoriatic arthritis and psoriasis

Daniel H Solomon  1 , Thorvardur Jon Love, Claire Canning, Sebastian Schneeweiss
Affiliations
Multicenter Study

Risk of diabetes among patients with rheumatoid arthritis, psoriatic arthritis and psoriasis

Daniel H Solomon et al. Ann Rheum Dis. 2010 Dec.

Abstract

Objective: To examine the risk of diabetes mellitus (DM) among subjects with rheumatoid arthritis (RA), psoriatic arthritis or psoriasis (PsA/PsO), compared with non-rheumatic controls.

Methods: Study cohorts were assembled using linked healthcare utilisation data from British Columbia. All people with at least two diagnoses of RA or PsA/PsO were included and compared with a cohort of people without any known rheumatic disease. The outcome of interest was a diagnosis of new-onset DM, as defined by initiation of an antidiabetic drug. Incidence rates (IRs) per 1000 person-years and IR ratios were calculated and Cox regression models were constructed to determine the hazard ratio (HR) for diabetes by age, gender, systemic immunosuppressive drug and glucocorticoid use.

Results: The study cohort comprised 48 718 subjects with RA, 40 346 with PsA/PsO and 442 033 without any rheumatic disease. The IR for DM among subjects with RA was 8.6 per 1000 person-years (95% CI 8.5 to 8.7), PsA/PsO 8.2 (95% CI 8.1 to 8.3) and for non-rheumatic controls 5.8 (95% CI 5.8 to 5.8). The adjusted HR for RA compared with non-rheumatic controls was 1.5 (95% CI 1.4 to 1.5) and 1.4 (95% CI 1.3 to 1.5) for PsA/PsO.

Conclusions: RA and PsA/PsO appear to be associated with an increased risk of DM. The ability of potent antirheumatic treatments to reverse this trend warrants study.

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Figures

Figure 1
Figure 1
This figure shows the Cox proportional hazard ratios for diabetes mellitus across age stratum. Panel A shows this for the total cohort, panel B for women, and panel C for men. All models were adjusted for the variables in Table 1.
Figure 1
Figure 1
This figure shows the Cox proportional hazard ratios for diabetes mellitus across age stratum. Panel A shows this for the total cohort, panel B for women, and panel C for men. All models were adjusted for the variables in Table 1.
Figure 1
Figure 1
This figure shows the Cox proportional hazard ratios for diabetes mellitus across age stratum. Panel A shows this for the total cohort, panel B for women, and panel C for men. All models were adjusted for the variables in Table 1.
See this image and copyright information in PMC

References

    1. Solomon DH, Karlson EW, Rimm EB, et al. Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation. 2003;107:1303–1307. - PubMed
    1. Gelfand JM, Neimann AL, Shin DB, et al. Risk of myocardial infarction in patients with psoriasis. JAMA. 2006;296:1735–1741. - PubMed
    1. Maradit-Kremers H, Nicola PJ, Crowson CS, et al. Cardiovascular death in rheumatoid arthritis: a population-based study. Arthritis & Rheumatism. 2005;52:722–732. - PubMed
    1. del Rincon ID, Williams K, Stern MP, et al. High incidence of cardiovascular events in a rheumatoid arthritis cohort not explained by traditional cardiac risk factors. Arthritis & Rheumatism. 2001;44:2737–2745. - PubMed
    1. Natali A, Toschi E, Baldeweg S, et al. Clustering of insulin resistance with vascular dysfunction and low-grade inflammation in type 2 diabetes. Diabetes. 2006;55:1133–1140. - PubMed

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