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Inflammation and inflammatory mediators may affect glucose and lipid metabolism through a number of pathways. However, effects and mechanisms seem to vary dramatically in different individuals and settings. In obese adults with metabolic syndrome and impaired glucose-tolerance, inflammatory mediators from fat tissue including tumour necrosis factor-alpha (TNF-α) further reduce glucose tolerance. In such patients, treatment with TNF-α-blocking agents has been shown to ameliorate glucose tolerance. However, in non-obese healthy adults, vigorous exercise may induce an inflammatory response including release of TNF-α. Glucose tolerance increases during and after the exercise, and TNF-α blocking agents may inhibit this beneficial effect. Furthermore, the positive effects of exercise on cholesterol and triglyceride levels have also been diminished by TNF-α blocking agents.  In children with juvenile idiopathic arthritis (JIA) treatment with TNF-α blocking agents is increasingly common as the treatment is efficient and well tolerated. The possible harmful effects of this treatment on glucose and lipid metabolism, however, give rise to concern.

PReS-FINAL-2026: Glucose and lipid metabolism in children with juvenile idiopathic arthritis treated with anti-TNF-alpha