Evaluation of insulin resistance by the homeostasis model assessment in female patients with Primary Sjogren's Syndrome

Objective: To evaluate insulin resistance in Primary Sjogren's Syndrome (pSS) using homeostasis model assessment (HOMA) method Design: Cross-sectional study conducted between January 2006 and December 2008 Setting: Ege University Faculty of Medicine, Izmir, Turkey Subjects: Thirty-fivefemalepatientswithpSSfulfillingtheUS-European Consensus Criteria Interventions: A brief clinical history, demographic, anthropometric, clinical and laboratory profileswererecorded Main Outcome Measures: HOMA-IR and serum lipid levels Results: Mean level of HOMA-IR was 1.8 ± 0.7 in patients with pSS. Mean levels of plasma fasting glucose and insulin were 90.6 ± 7.1 mg/dl, 7.8 ± 2.5 microU/l, respectively. A statistically significantdifferencewasdetectedbetweenANA positivity and HOMA-IR values (p = 0.016). Four patients with pSS had high HOMA values (> 2.7) and all these patients had ANA positivity. A statistically significantpositive correlation was detected between HOMA-IR values and HDL-C levels (R = 0,450 p = 0.009). However, a statistically significantdifferencewasdetectedbetweenextraglandularinvolvement and LDL-C (p = 0.01) and total cholesterol levels (p = 0.01). Patients who had no extraglandular involvement had higher levels of total cholesterol and LDL-C levels. Lower triglyceride levels were seen in patients with anti-La antibodies (p = 0.01) but not other antibodies (p > 0.05). Patients with ANA positivity and pSS had lower LDL-C levels (p = 0.009). Conclusion: Autoimmune mechanisms may play a role in insulin resistance in pSS. Metabolic alterations should be taken into account in their management.