RESUMO
OBJECTIVE: To investigate insulin sensitivity and beta cell function in female systemic lupus erythematosus (SLE) patients with different glucose tolerances. METHODS: Insulin sensitivity and beta cell function were compared between SLE patients and non-SLE subjects in the states of normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and diabetes mellitus (DM) respectively. Furthermore, risk factors for insulin sensitivity and beta cell function in SLE patients were analysed by linear regression. RESULTS: In NGT state, insulin sensitivity and beta cell function of newly diagnosed SLE patients without glucocorticoids treatment were not significantly different from those of normal control group (P < 0.05). Compared with newly diagnosed SLE patients without glucocorticoids treatment and normal control group, HOMA insulin resistance index (HOMA-IR), ln (HOMA-ß), ln (early phase insulin secretion index, EISI) and ln (late phase insulin secretion index, LISI) of SLE patients with glucocorticoids treatment were significantly higher (1.91 ± 1.04 vs 0.81 ± 0.75, 0.94 ± 0.27; 5.05 ± 0.65 vs 4.01 ± 0.63, 4.23 ± 0.47; 3.14 ± 0.81 vs 2.42 ± 0.39, 2.50 ± 0.65; 2.30 ± 0.55 vs 1.62 ± 0.57, 1.56 ± 0.43; P < 0.05), while ln (Matsuda index, MI) was significantly lower (4.53 ± 0.54 vs 5.27 ± 0.68, 5.18 ± 0.38; P < 0.05). In IGT and DM state, HOMA-IR (2.84 ± 1.87 vs 1.82 ± 1.22, 3.18 ± 2.29 vs 2.94 ± 2.26) and ln (HOMA-ß) (5.18 ± 0.93 vs 4.06 ± 0.58, 3.99 ± 1.04 vs 3.43 ± 0.83) were significantly higher in SLE patients with glucocorticoids treatment than those of non-SLE subjects (P < 0.05) respectively. BMI and ln (daily glucocorticoids doses) were independent risk factors for insulin sensitivity, and age, the SLE disease activity index (SLEDAI) and ln (daily glucocorticoids doses) were related factors beta cell function. CONCLUSION: In NGT, IGT and DM state, SLE female patients with glucocorticoids treatment have reduced insulin sensitivity and increased beta cell function, these changes are related to the use of glucocorticoids.