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Oxidative Medicine and Cellular Longevity
Volume 2016 (2016), Article ID 8962763, 9 pages
Clinical Study

Influence of Insulin Resistance and TNF-α on the Inflammatory Process, Oxidative Stress, and Disease Activity in Patients with Rheumatoid Arthritis

1Department of Rheumatology, University of Londrina (UEL), Londrina, PR, Brazil
2Department of Clinical Analysis, University North of Paraná (UNOPAR), Londrina, PR, Brazil
3Department of Clinical Pathology, University of Londrina, Robert Koch Avenue No. 60 Bairro Cervejaria, Londrina 86038-440, PR, Brazil
4Department of Internal Medicine, University of Londrina, Londrina, PR, Brazil

Received 8 December 2015; Accepted 19 April 2016

Academic Editor: Victor M. Victor

Copyright © 2016 Neide Tomimura Costa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The aim of this study was to evaluate the involvement of TNF-α and insulin resistance (IR) in the inflammatory process, oxidative stress, and disease activity in patients with rheumatoid arthritis (RA). This cross-sectional study included 270 subjects (control group, ) and RA patients (). RA patients were divided into four groups: the first group without IR and not using antitumor necrosis factor-α () (G1, IR− TNF−); the second group without IR and using anti-TNF-α (G2, TNF+); the third group with IR and not using anti-TNF-α (G3, IR+ ); and the fourth group with IR and using anti-TNF-α (G4, IR+ TNF+). G3 and G4 had higher () advanced oxidation protein products (AOPPs) and oxidative stress index (OSI) compared to G1. G4 group presented higher () AOPPs and OSI than G2. TRAP was significantly lower in G3 compared to G1. Plasma TNF-α levels were significantly higher in G4 and G2 compared to G1 () and G3 ( and , resp.). The presence of insulin resistance was robustly associated with both oxidative stress and TNF-α levels. More studies are warranted to verify if IR can be involved in therapeutic failure with TNF-α inhibitors. This trial is registered with Brazilian Clinical Trials Registry Register number RBR-2jvj92.