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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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Prevalence of diabetes mellitus in biopsy-positive giant cell arteritis

Jared L Matthews1, David N Gilbert, Bradley K Farris

  • 1University of Oklahoma College of Medicine, Oklahoma City, OK, USA. JMatthews2@med.miami.edu

Journal of Neuro-Ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society
|May 3, 2012
PubMed
Abstract

Insights

Patients with diabetes mellitus (DM) are less likely to have biopsy-positive giant cell arteritis (GCA). This finding suggests reconsidering diagnostic suspicion in diabetic patients with potential GCA.

Area of Science:

  • Rheumatology
  • Endocrinology
  • Pathology

Background:

  • Giant cell arteritis (GCA) is a systemic vasculitis.
  • The association between diabetes mellitus (DM) and GCA is not well understood.
  • This study investigates the prevalence of DM in biopsy-positive GCA cases.

Purpose of the Study:

  • To test the hypothesis that patients with DM develop biopsy-positive GCA less frequently than nondiabetic patients.
  • To compare DM prevalence in patients with positive vs. negative temporal artery biopsies (TAB).
  • To conduct a meta-analysis of existing literature on DM and biopsy-proven GCA.

Main Methods:

  • Retrospective study of 215 patients undergoing TAB.
  • Classification of biopsy-positive GCA based on microscopic examination.
  • Definition of DM based on medical history or medication use.
  • Meta-analysis of 8 published studies including 1,401 additional GCA cases.

Main Results:

  • In the study cohort, only 9.1% of biopsy-positive GCA cases had DM.
  • A significantly lower prevalence of DM was observed in biopsy-positive GCA patients compared to those with negative TAB (9.1% vs. 35.7%, P = 0.0006).
  • Meta-analysis revealed a combined DM prevalence of 6.35% in 1,401 biopsy-proven GCA cases.

Conclusions:

  • The low frequency of biopsy-positive GCA in diabetic patients warrants consideration when evaluating suspected GCA.
  • Further research is necessary to elucidate the interaction between DM and GCA.
  • Diagnostic suspicion for GCA may need adjustment in diabetic individuals.

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