Given that inflammation is a key factor in the onset and progression of DM and that RA is an inflammatory autoimmune disease, an association between the two conditions seems probable. A systematic review and meta-analysis were conducted to investigate the relation between RA and the incidence of DM [1].
Dr Zixing Tian (University of Manchester, United Kingdom) and colleagues presented the results of their comprehensive search up to March 10, 2020 in Medline, Embase, and the Web of Science core collection to identify cohort studies comparing DM incidence in people with RA to that in the general population. This resulted in 3,667 articles from which 47 studies were identified after screening. Of those, 5 journal articles and 2 conference abstracts comprising a total of 1,629,854 patients were included in this meta-analysis. All studies were retrospective and all but one hospital study were population-based.
RA was associated with a higher risk of DM (pooled relative risk 1.23; 95% CI 1.07-1.40). In a sensitivity analysis, excluding the hospital study did not materially change the result (pooled relative risk 1.23; 95% CI 1.06-1.42). A funnel plot showed potential publication bias which was proven by Egger’s test (-3.15, P<0.01) but not by Begg’s test (-0.05, P=1.00).
The researchers asserted that intensive screening and management of DM risk factors should be considered in people with RA. Drugs that reduce systemic inflammation may be effective in lowering the incidence of DM and possibly RA as well through targeting more than one pathway at a time.
- Tian Z, et al. The relation between rheumatoid arthritis and diabetes incidence: a systematic review and meta-analysis. EASD 2020. Abstract #271.
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