{
  "abstract": "Introduction Insulin resistance (IR) is a relevant metabolic concern in patients with rheumatic diseases, potentially impacting disease phenotype and outcomes. This study aimed to evaluate the clinical, serological, metabolic, and therapeutic characteristics associated with IR in a well-characterized monocentric SSc cohort.Material and Methods We conducted a cross-sectional analysis of 178 patients with SSc, stratified according to the presence or absence of insulin resistance (IR). Given the lack of a universally accepted validated cut-off for HOMA-IR, IR was defined as a HOMA-IR value >1.85 for men and >2.07 for women, based on thresholds previously validated in a large general adult population for the identification of metabolic syndrome in the EPIRCE cross-sectional study. Data collected included demographic, clinical, laboratory, pulmonary function, capillaroscopic, and treatment-related parameters. Chi-square, Fischer Exact, T student and Mann Whitney test were used for comparisons as appropriate. A multivariable logistic regression model was used to identify independent predictors of insulin resistance. IBM SPSS v.27 was used for statistical analysis and a threshold of p<0.05 was considered statistically significant.Results Patients with IR (n=76) had significantly higher fasting glucose, insulin, HOMA-IR, and HbA1c levels (all p<0.01), with more frequent dyslipidemia and liver steatosis as relevant comorbidities ( table 1 and 3). HDL cholesterol was lower, and triglycerides were higher in the IR group (both p<0.001) (table 1). ILD, musculoskeletal symptoms, microstomia, and digital ulcers were more prevalent in the IR group, as was the diffuse cutaneous SSc subset (table 2). Anti-Scl70 and rare autoantibodies were more common among IR patients (table 2). Lung involvement as the first non-Raynaud symptom was significantly associated with IR (p=0.016), while vascular onset was more frequent in non-IR patients (p=0.002) (table 2). Medications such as corticosteroids, hydroxychloroquine, statins, and Iloprost were more frequently used in the IR group (table 4). No differences were noticed regarding Nail-fold videocapillaroscopic pattern, however a trend toward significance was detected for early changes for the non-IR group (figure 1). Figure 2 shows main differences regarding pulmonary function tests comparing the two groups and IR patients exhibited reduced values of FVC% predicted, while increased values of DLCO% corrected for alveolar volume (p<0.01 and p<0.001, respectively). In multivariable logistic regression analysis, BMI (OR 1.09; p=0.038) and interstitial lung disease (OR 3.03; p=0.034) were independent predictors of IR in our population.Conclusions In SSc, IR is associated with metabolic dysregulation, more severe disease phenotype and specific autoantibodies profile. These findings suggest a potential link between metabolic and fibrotic pathways.Abstract P.407 Figure 1Nail-fold Videocapillaroscopy pattern distribution across SSc population devided by the presence or absence of Insulin resistanceAbstract P.407 Figure 2PFTs measurements comparisonAbstract P.407 Table 1Comparative univariable analysis of laboratory parameters across SSe population devided by the presence of insulin resistanceAbstract P.407 Table 2Demographic and clinical characteristies of SSe populations by comparing patients with and without insulin resistanceAbstract P.407 Table 3Univariable analysis of comorbidities of SSe popularion by comparing patients with and without Insulin resistanceAbstract P.407 Table 4Medications status across SSe population comparing patients with and without insulin resistanceAbstract P.407 Table 5Multivariable logistic regression model by selecting the presence of insulin resistance as dependent variable",
  "authors": [
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Eugenio Capparelli"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Paola Faggioli"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Eleonora Zaccara"
    },
    {
      "affiliations": [
        "Internal Medicine Unit, ASST Ovest Milanese, Legnano Hospital, Via Papa Giovanni Paolo II, Legnano, Milan, Ital, Milan, Italy"
      ],
      "name": "Francesco Lapia"
    },
    {
      "affiliations": [
        "Internal Medicine Unit, ASST Ovest Milanese, Legnano Hospital, Via Papa Giovanni Paolo II, Legnano, Milan, Ital, Milan, Italy"
      ],
      "name": "Francesca Capelli"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Laura Castelnovo"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Daniela Bompane"
    },
    {
      "affiliations": [
        "Rheumatology Unit, ASST Ovest Milanese, Legnano Hospital, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Antonio Tamburello"
    },
    {
      "affiliations": [
        "Laboratory of Clinical Chemistry, ASST Ovest Milanese, Hospital of Legnano, Legnano, Milan, Italy., Milan, Italy"
      ],
      "name": "Sergio Finazzi"
    },
    {
      "affiliations": [
        "Rheumatology, Allergology and Clinical Immunology, Department of Systems Medicine, University of Rome Tor Vergata, Ro, Rome, Italy"
      ],
      "name": "Maria Sole Chimenti"
    },
    {
      "affiliations": [
        "Internal Medicine Unit, ASST Ovest Milanese, Legnano Hospital, Via Papa Giovanni Paolo II, Legnano, Milan, Ital, Milan, Italy"
      ],
      "name": "Antonino Mazzone"
    }
  ],
  "title": "P.407 Metabolic and clinical correlates of insulin resistance in systemic sclerosis: a cross-sectional monocentric study",
  "uid": "aec34167-771c-5812-9f34-6c2f92c945ed"
}