Treatment with Anakinra Improves Disposition Index But Not Insulin Sensitivity in Nondiabetic Subjects with the Metabolic Syndrome: A Randomized, Double-Blind, Placebo-Controlled Study

Context: Obesity induces low-grade inflammation that may promote the development of insulin resistance. IL-1 is one of the key inflammatory factors. Objective: The objective of the study was to demonstrate improvement of insulin sensitivity by blocking IL-1. Design: This was a randomized, double-blind, crossover study. Setting: The study was based on ambulatory care. Participants: Participants included nondiabetic, obese subjects with the metabolic syndrome. Intervention: Intervention included 150 mg anakinra sc once daily or matching placebo for 4 wk. Main Outcome Measure: Insulin sensitivity as measured by euglycemic hyperinsulinemic clamp. Results: A total of 13 of 19 subjects completed the study. Although anakinra treatment resulted in a significantly lower level of inflammation illustrated by a reduction in circulating C-reactive protein concentrations and leukocyte numbers, insulin sensitivity was not significantly different after anakinra treatment (2.8 × 10−2 ± 0.5 × 10−2) compared with placebo tr...