Baseline Serum Adipokine Levels Predict Radiographic Progression in Early Rheumatoid Arthritis
Baseline Serum Adipokine Levels Predict Radiographic Progression in Early Rheumatoid Arthritis
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DOI：
10.1002/art.30449
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发表时间：
2011-09-01
影响因子：
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通讯作者：
Ioan-Facsinay, Andreea
中科院分区：
文献类型：
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作者：
Klein-Wieringa, Inge R.;van der Linden, Michael P. M.;Ioan-Facsinay, Andreea
目标。脂肪组织可以分泌具有强大免疫调节功能的可溶性介质(脂肪因子)。一些脂肪因子以前被认为与类风湿性关节炎(RA)患者的放射学损害有关。在这项研究中，我们调查了基线脂肪因子水平预测4年内放射学进展的能力，并研究了它们相对于其他已知危险因素的贡献，如抗环瓜氨酸肽(抗CCP)抗体。对253例早期类风湿关节炎患者进行血清瘦素、内脂素、抵抗素、脂联素、脂联素、肿瘤坏死因子-α和白介素6的测定。使用校正了年龄、性别、治疗策略、体重指数(BMI)和抗CCP抗体的多变量正态回归模型来确定这些脂肪因子水平与放射学进展之间的关系。IL-6、肿瘤坏死因子α、内脂素和脂联素水平与4年后的放射学进展呈正相关。这种关联独立于BMI。然而，当模型校正了抗CCP抗体的存在时，只有脂联素水平仍然与放射学进展显著相关，而IL-6则有趋势。在校正了抗CCP抗体的存在后，肿瘤坏死因子α和内脂素与放射学损伤的相关性消失，这与这两种细胞因子水平与抗CCP抗体水平显著相关的事实相一致。我们的结果表明，脂肪因子是RA放射学进展的预测因子，可能是通过不同的潜在生物机制。
Objective. Adipose tissue can secrete soluble mediators (adipokines) with potent immune regulatory functions. Some adipokines have been previously associated with radiographic damage in patients with rheumatoid arthritis (RA). In the present study, we investigated the capacity of baseline adipokine levels to predict radiographic progression over a period of 4 years and studied their contribution relative to that of other known risk factors, such as anti-cyclic citrullinated peptide (anti-CCP) antibodies.Methods. Serum concentrations of leptin, visfatin, resistin, adiponectin, adipsin, tumor necrosis factor alpha (TNF alpha), and interleukin-6 (IL-6) were determined in serum samples obtained at baseline from 253 patients with RA from the Early Arthritis Cohort. The association between levels of these adipokines and radiographic progression was determined using a multivariate normal regression model correcting for age, sex, treatment strategy, body mass index (BMI), and the presence of anti-CCP antibodies.Results. Levels of IL-6, TNF alpha, visfatin, and adiponectin were positively associated with radiographic progression over 4 years. This association was independent of BMI. However, only adiponectin levels remained significantly associated with radiographic progression when the model was corrected for the presence of anti-CCP antibodies, whereas a trend was observed for IL-6. The association of both TNF alpha and visfatin with radiographic damage disappeared after correction for the presence of anti-CCP antibodies, which is consistent with the fact that the levels of both cytokines correlated significantly with anti-CCP antibody levels in these patients.Conclusion. Our results indicate that adipokines are predictors of radiographic progression in RA, possibly through distinct underlying biologic mechanisms.