Abstract
Background: Increase in insulin resistance predisposes to cardiovascular disease. Studies from various parts of world show increase prevalence of IR in rheumatoid arthritis (RA) but there is little data from India.

Aims and Objectives: To evaluate the prevalence of IR in RA and after 6 months of treatment with disease-modifying antirheumatic drugs.

Materials and Methods: This hospital-based longitudinal observational study was done between July 2018 and June 2019 in the Division of Rheumatology, Department of General Medicine, S.S. Hospital, BHU, in treatment-naive RA patients with age ≥18 years. Exclusion criteria were known diabetes, preexisting dyslipidemias, or any other chronic illness. Detailed history and examination were done. Fasting glucose and fasting insulin were done to calculate the homeostatic model for assessment of IR (HOMA IR).

Results: The most common age group in our study was 31–40 years (38%). The mean age of onset of disease was 39.5 years. Female-to-male ratio was 5.25:1. The mean duration of illness was 3 years with baseline mean disease activity score (DAS) 28 score 6.2698 ± 1.07437. Baseline mean cholesterol level, triglyceride, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein were 169.40 ± 33.802 mg/dL, 164.42 ± 91.585 mg/dL, 47.66 ± 11.825 mg/dL, 99.88 ± 27.059 mg/dL, and 34.42 ± 19.186 mg/dL, respectively. Baseline fasting blood glucose levels, fasting insulin levels, and HOMA IR were 99.40 ± 20.761 mg/dL, 11.84770 ± 4.351550 m IU/L,and 2.905 ± 1.2272, respectively. After treatment of 6 months, lipid profile, fasting insulin, and HOMA IR improved significantly. However, there was no significant correlation found between IR and disease activity before and after treatment.

Conclusion: The patients of RA are at higher risk of IR and dyslipidemia and early diagnosis with the initiation of treatment for RA can reverse the IR in RA patients.

Key words: Insulin Resistance; Rheumatoid Arthritis; Homeostatic Model for Assessment of Insulin Resistance; Fasting Blood Glucose; Inflammation; Cardiovascular Disease