Response to: ‘Correspondence on ‘Disease activity, cytokines, chemokines and the risk of incident diabetes in rheumatoid arthritis’’ by Ruscitti et al

We were pleased to read the commentary on our recent article by Ruscitti et al and we share their interest in the potential role of inflammatory pathways in the development of metabolic disorders such as diabetes in patients with rheumatoid arthritis (RA).1 Indeed, both interleukin (IL)-1 and IL-6 levels were independently associated with the development of diabetes in our original study, implicating them as potential mediators of metabolic changes that could lead to the development of diabetes.2 Observational research is, of course, limited to defining associations and cannot prove causality. In our study, as in many large observational studies, we were unable to assess total adiposity or to assess visceral fat content; factors that play an important role in diabetes risk …