Dr. Stein holds the Dan May Chair in Medicine at Vanderbilt University.
Rheumatoid Arthritis Clinical Studies
Adipocytokines are associated with radiographic joint damage in rheumatoid arthritis
Article first published online: 29 JUN 2009
Copyright © 2009 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 60, Issue 7, pages 1906–1914, July 2009
How to Cite
Rho, Y. H., Solus, J., Sokka, T., Oeser, A., Chung, C. P., Gebretsadik, T., Shintani, A., Pincus, T. and Stein, C. M. (2009), Adipocytokines are associated with radiographic joint damage in rheumatoid arthritis. Arthritis & Rheumatism, 60: 1906–1914. doi: 10.1002/art.24626
- Issue published online: 29 JUN 2009
- Article first published online: 29 JUN 2009
- Manuscript Accepted: 26 MAR 2009
- Manuscript Received: 13 NOV 2008
- NIH (National Heart, Lung, and Blood Institute). Grant Numbers: HL-65082, HL-67964
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. Grant Number: P60-AR-056116
- National Center for Research Resources. Grant Number: UL1-RR-024975
- National Institute of General Medical Sciences. Grant Number: GM-07569
Obesity protects against radiographic joint damage in rheumatoid arthritis (RA) through poorly defined mechanisms. Adipocytokines are produced in adipose tissue and modulate inflammatory responses and radiographic joint damage in animal models. The purpose of this study was to examine the hypothesis that adipocytokines modulate inflammation and radiographic joint damage in patients with RA.
We compared serum concentrations of leptin, resistin, adiponectin, and visfatin in 167 RA patients and 91 control subjects. The independent association between adipocytokines and body mass index (BMI), measures of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6], and tumor necrosis factor α [TNFα]), and radiographic joint damage (Larsen score; n = 93 patients) was examined in RA patients by multivariable regression analysis first controlling for age, race, and sex, and then for obesity (BMI) and inflammation (TNFα, IL-6, and CRP).
Concentrations of all adipocytokines were significantly higher in RA patients than in controls; for visfatin and adiponectin, this association remained significant after adjusting for BMI, inflammation, or both. Visfatin concentrations were associated with higher Larsen scores, and this association remained significant after adjustment for age, race, sex, disease duration, BMI, and inflammation (odds ratio [OR] 2.38 [95% confidence interval (95% CI) 1.32–4.29], P = 0.004). Leptin concentrations showed a positive association with the BMI (ρ = 0.58, P < 0.01) and showed a negative association with the Larsen score after adjustment for inflammation (OR 0.32 [95% CI 0.17–0.61], P < 0.001), but not after adjustment for BMI (OR 0.86 [95% CI 0.42–1.73], P = 0.67).
Concentrations of adipocytokines are increased in patients with RA and may modulate radiographic joint damage. Visfatin is associated with increased, and leptin with reduced, levels of radiographic joint damage.