The relationship between rheumatoid arthritis and diabetes mellitus: a systematic review and meta-analysis.
diabetes mellitus
incidence
inflammation
meta-analysis
rheumatoid arthritis
Journal
Cardiovascular endocrinology & metabolism
ISSN: 2574-0954
Titre abrégé: Cardiovasc Endocrinol Metab
Pays: United States
ID NLM: 101730894
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
28
08
2020
accepted:
10
12
2020
entrez:
14
6
2021
pubmed:
15
6
2021
medline:
15
6
2021
Statut:
epublish
Résumé
This systematic review/meta-analysis was conducted to investigate the relationship between rheumatoid arthritis and the incidence of diabetes mellitus. A comprehensive search was conducted up to 10 March 2020 in Medline (via Ovid), Embase (via Ovid) and Web of Science core collection to identify cohort studies comparing the risk of diabetes mellitus incidence in people with rheumatoid arthritis with the general population. The I2 statistic was used to test heterogeneity. Pooled relative risks were calculated using random-effects models. Publication bias was assessed using Egger's test and Begg's test. The initial search provided 3669 articles. Of those, five journal articles/two conference abstracts comprising 1 629 854 participants were included in this study. The funnel plot showed potential publication bias, proven by Egger's test (-3.15, P < 0.01), but not Begg's test (-0.05, P = 1.00). Heterogeneity was observed in I2 test (I2 = 96%, P < 0.01). We found that rheumatoid arthritis was associated with a higher risk of diabetes mellitus incidence (pooled relative risk, 1.23; 95% confidence interval, 1.07-1.40). Exploration of potential sources of heterogeneity found significant heterogeneity in different countries/regions (P = 0.002), but heterogeneity was NS in different study designs (P = 0.30). Sensitivity analyses confirmed that the association between rheumatoid arthritis and diabetes mellitus incidence was robust. Rheumatoid arthritis is associated with an increased risk of diabetes mellitus incidence. This finding supports the notion that inflammatory pathways are involved in the pathogenesis of diabetes. More intensive interventions targeting diabetes risk factors should be considered in people with rheumatoid arthritis.
Identifiants
pubmed: 34124603
doi: 10.1097/XCE.0000000000000244
pmc: PMC8189616
doi:
Types de publication
Journal Article
Langues
eng
Pagination
125-131Informations de copyright
Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
Z.T. is supported by China Scholarship Council. H.C. is supported by the National Institute for Health Research Biomedical Research Centre Funding Scheme. For the remaining authors, there are no conflicts of interest.
Références
BMJ. 2016 Nov 23;355:i5953
pubmed: 27881363
N Engl J Med. 2011 Dec 8;365(23):2205-19
pubmed: 22150039
Arthritis Rheum. 2002 Sep;46(9):2287-93
pubmed: 12355475
Arthritis Care Res (Hoboken). 2019 Apr;71(4):498-511
pubmed: 29856128
Trends Endocrinol Metab. 2000 Aug;11(6):212-7
pubmed: 10878750
Atherosclerosis. 2008 Feb;196(2):756-63
pubmed: 17266963
J Rheumatol. 2013 Sep;40(9):1513-8
pubmed: 23818711
Clin Exp Rheumatol. 2015 Jan-Feb;33(1):115-21
pubmed: 25535750
Lancet. 2010 Sep 25;376(9746):1094-108
pubmed: 20870100
Joint Bone Spine. 2011 Mar;78(2):179-83
pubmed: 20851020
Lancet. 2017 Jun 3;389(10085):2239-2251
pubmed: 28190580
Arthritis Care Res (Hoboken). 2017 Jan;69(1):51-57
pubmed: 27696731
Cell Metab. 2013 Jun 4;17(6):860-872
pubmed: 23747245
Arthritis Care Res (Hoboken). 2017 Oct;69(10):1495-1503
pubmed: 27998044
Nat Rev Immunol. 2019 Dec;19(12):734-746
pubmed: 31501536
Ann Rheum Dis. 2008 Jan;67(1):64-9
pubmed: 17517756
Ann Rheum Dis. 2010 Dec;69(12):2114-7
pubmed: 20584807
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
Nat Rev Endocrinol. 2010 Mar;6(3):158-66
pubmed: 20173777
Autoimmun Rev. 2019 Jul;18(7):679-690
pubmed: 31059840