A STUDY OF INSULIN RESISTANCE IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

Background Systemic lupus erythematosus (SLE) is the prototypic autoimmune chronic inammatory disorder that predominantly affects women during their reproductive years and characterized by multisystem organ involvement and by high titres of auto-antibodies against several nuclear and cytoplasmic antigens. Increased risk of CHD in SLE is not explained by classic CHD risk factors.Insulin resistance and Metabolic syndrome are clearly strong candidates to justify the increase in CHD in patients with SLE and they provide insights into the pathogenesis of insulin resistance associated with inammation. Insulin resistance is a key component of the World Health Organization–dened metabolic syndrome that is increased in patients with SLE. The study was carried out in All SLE patients attending Rheumatology OPD and other outpatientMethods department or in various ward of Department of medicine at Assam medical College and hospital satisfying the inclusion criteria.continuous variables were expressed as mean +-standard deviation.categorical variable were expressed as frequency and percentage.p value were considered statistically signicant when it was less than 0.05 In our study ,the most common age group was found to be between 21-25 years(28%)Results followed by 16-20 years(20%).The female accounts for 96% and male accounts for 4%.From the study ,it was found that 47% of the study population had insulin resistance compared to 16% of that of healthy control.it indicates presence of signicant insulin resistance in the study group (p value<0.05). The mean HOMA-IR score in the case was 3.54±3.41 and that in the control was 1.97±1.27. In the study conducted by C_intia N. H. Miyake et al , they found the similar result. The mean HOMA-IR score in the case and control were 1.85±1.68 and 1.40±0.86 respectively. (p value <0.05). Sanaa Gazareen et al study also showed signicant insulin resistance in study group compared to control group. The mean HOMA-IR score in case was 1.5±0.86 and that in the control was 0.84±0.27.There was no signicant difference in insulin resistance between male and female.There was no signicant difference in insulin resistance between the newly diagnosed cases and the previously diagnosed cases who were on treatment.from the study it was also found that, as the disease activity increased,insulin resistance was also increased with co-relation coefcient(R) is 0.6053 and it was statistically signicant (p value<0.05). Systemic lupus erythematosus (SLE) is a chronic,Conclusions multifaceted inammatory disease that can attack every organ system of the body. As the overall prognosis for persons with SLE has improved in recent time due availability of medications but cardio-vascular morbidity or mortality has been increasing rapidly. In recent studies of SLE, we have seen a marked increase in the prevalence of the metabolic syndrome. Insulin resistance is a key component of the World Health Organization–dened metabolic syndrome that is increased in patients with SLE In this part of the country, 47% of the SLE cases were having insulin resistance compared to 16% of the healthy population ( p value <0.05). There was no difference in insulin resistance in SLE cases who were newly diagnosed not on medication and the diagnosed cases those were on medication. Insulin resistance was signicantly associated with disease activity. There was no co-relation of insulin resistance with disease duration. Fasting serum insulin level was signicantly higher in SLE cases with insulin resistance compared to cases without insulin resistance. Though triglyceride level was signicantly higher in SLE cases compared to healthy population but there was no difference in fasting lipid prole parameters in cases with insulin resistance and in cases without insulin resistance.