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-five female patients with pSS fulfilling the US-European Consensus Criteria Interventions: A brief clinical history, demographic, anthropometric, clinical and laboratory profiles were recorded 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/di, 7.8 +/- 2.5 microU/1, respectively. A statistically significant difference was detected between ANA 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 significant positive correlation was detected between HOMA-IR values and HDL-C levels (R = 0,450 p = 0.009). However, a statistically significant difference was detected between extraglandular involvement 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 LDLC 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 LDLC 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.