Background: chronic inflammatory disorders such as rheumatoid arthritis are associated especially 
active disease are associated with disturbed glucose and lipid metabolism, this underlying metabolic 
disorders such as insulin resistance. Objectives: The aim of this study was to determine insulin 
resistance and its relation to disease activity in patients with RA. Methods: Sixty RA patients 
fulfilling the 2010 ACR/EULAR RA Classification Criteria were included in the study. Thirty ageand sex-matched healthy volunteers were enrolled as the control group. All subjects underwent full 
history taking, clinical examination. BMI was calculated. Waist/hip ratio was measured. RA disease 
activity was assessed by DAS28-ESR. The following laboratory investigations were done for all 
patients and control: HbA1c, lipid profile and insulin. Insulin resistance was assessed with the HOMA 
Index. Echocardiography for cardiac abnormalities. Results: The frequency of cardiovascular (CV) 
involvement in our RA patients was 11.6% with echocardiography. Patients had higher insulin 
resistance than controls with no statistically significant difference. RA patients with CV involvement 
showed increased disease activity in comparison with patients without CV involvement, and no 
significant difference in insulin levels nor resistance between them. Conclusions: Rheumatoid 
arthritis has higher insulin resistance than controls, with no correlation to disease activity.