Analysis of the Interactive Effects of Diabetes and Dyslipidemia on the Treatment Efficacy of Rheumatoid Arthritis and Their Predictive Significance
10.12259/j.issn.2095-610X.S20250716
- VernacularTitle:糖尿病、血脂交互影响类风湿性关节炎疗效的作用分析及预测意义
- Author:
Maoyi YANG
1
;
Shangli LIU
;
Wenjing YU
;
Lei LIU
Author Information
1. 四川省骨科医院风湿疼痛科,四川 成都 610000
- Keywords:
Rheumatoid arthritis;
Diabetes;
Dyslipidemia;
Treatment efficacy;
Predictive factors
- From:
Journal of Kunming Medical University
2025;46(7):131-138
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the interactive effects of diabetes and lipid abnormalities on the treatment efficacy of rheumatoid arthritis(RA)and their predictive significance,providing a basis for individualized treatment of RA patients with metabolic disorders.Methods A total of 180 RA patients who visited the hospital between June 2022 and June 2023 were selected as research subjects.Based on whether patients had diabetes and dyslipidemia,they were divided into Group A(RA only,n=45),Group B(RA with diabetes,n=45),Group C(RA with dyslipidemia,n=45),and Group D(RA with both diabetes and dyslipidemia,n=45).All patients received conventional anti-rheumatic treatment according to the 2018 Chinese Rheumatoid Arthritis Diagnosis and Treatment Guidelines.Patients in Group B and D were additionally treated with metformin for blood glucose control,while patients in Group C and D received statins for lipid regulation.Treatment efficacy was assessed after 3 months of treatment.The Observed indicators included American College of Rheumatology(ACR)20/50/70 response rates,Disease Activity Score(DAS28),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),glycated hemoglobin(HbA1c),fasting plasma glucose(FPG),total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),and high-density lipoprotein cholesterol(HDL-C).Multivariate logistic regression analysis was used to evaluate the impact of blood glucose and lipid levels on RA treatment efficacy.Additive and multiplicative models were constructed to evaluate the interaction between HbA1c and HDL-C.Results After treatment,Group A showed significantly higher ACR20/50 response rates than the other three groups,and also showed a higher trend in ACR70 response rate.Group D had the lowest response rates across all criteria(P<0.05).Group D also exhibited significantly higher levels of DAS28,CRP,and ESR than the other three groups,while Group A had the lowest levels(P<0.05).Baseline HbA1c level,baseline HDL-C level and baseline DAS28 scores are independent influencing factors for ACR20 response(P<0.05).Comparison of additive and multiplicative models suggested that the effects of HbA1c and HDL-C on ACR20 response might be independent of each other(P=0.652).Conclusion Diabetes and dyslipidemia have significant negative impacts on RA treatment efficacy,but their interaction is not significant.For RA patients with metabolic disorders,it is important to actively control blood glucose and regulate lipid levels while undergoing anti-rheumatic treatment to improve therapeutic outcomes.Baseline HbA1c and HDL-C levels can serve as important predictors for RA treatment response.
