Plasma Adiponectin in Patients with Active, Early, and Chronic Rheumatoid Arthritis Who Are Steroid- and Disease-Modifying Antirheumatic Drug-Naive Compared with Patients with Osteoarthritis and Controls
Plasma Adiponectin in Patients with Active, Early, and Chronic Rheumatoid Arthritis Who Are Steroid- and Disease-Modifying Antirheumatic Drug-Naive Compared with Patients with Osteoarthritis and Controls
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DOI：
10.3899/jrheum.080907
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发表时间：
2009-09-01
影响因子：
3.9
通讯作者：
Stengaard-Pedersen, Kristian
中科院分区：
文献类型：
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作者：
Laurberg, Trine Bay;Frystyk, Jan;Stengaard-Pedersen, Kristian
目标。类风湿关节炎(RA)是一种全身性慢性炎症性关节疾病，而骨关节炎(OA)是一种局部关节疾病，具有低水平的炎症活动。脂肪细胞因子脂联素在这些疾病中的致病作用在很大程度上是未知的。我们假设(1)健康对照组和早期服用抗风湿药物(DMARD)的初治RA、慢性RA和OA患者的血浆脂联素浓度不同；(2)在甲氨蝶呤(MTX)治疗慢性RA期间观察到脂联素的变化；(3)脂联素与RA的疾病活动性指标相关。血浆脂联素采用有效的室内免疫分析方法进行分析。我们测定了健康对照组(n=45)、早期DMARD-幼稚RA患者(n=40)、慢性RA患者(n=74)和骨性关节炎患者(n=35)的脂联素水平。在一组慢性RA患者(n=31)中，研究了MTX治疗对脂联素的纵向影响(0周与28周)。脂联素在正常对照组(平均4.8+/-SD 2.7 mg/L)与3组间有显著差异，早期RA为8.9+/-4.8 mg/L，慢性RA为11.6+/-5.6 mg/L，OA为14.1+/-6.4 mg/L。在纵向上，甲氨蝶呤治疗使脂联素显著升高，从0周的9.7+/-4.5 mg/L上升到28周的11.0+/-4.5 mg/L。未发现疾病活动性指标的相关性。与健康对照组相比，早期DMARD幼稚和慢性RA患者的血浆脂联素水平较高，而血浆脂联素水平较OA低。在MTX治疗期间，脂联素增加了13%。在类风湿性关节炎和骨性关节炎患者中，体重指数、年龄、性别和疾病活动度的测量未能解释这一发现。(2009年8月15日首次发布；J Rheumatol 2009年；36：1885-91 DOI：10.3899/jhurum.080907)
Objective. Rheumatoid arthritis (RA) is a systemic chronic inflammatory joint disease, whereas osteoarthritis (OA) is a local joint disease with low-level inflammatory activity. The pathogenic role of the adipocytokine adiponectin is largely unknown in these diseases. We hypothesized (1) that plasma adiponectin concentrations differ in healthy controls and patients with early disease-modifying antirheumatic drug (DMARD)-naive RA, chronic RA, and OA; (2) that changes in adiponectin are observed during methotrexate (MTX) treatment of chronic RA; and (3) that adiponectin correlates to disease activity measures in RA.Methods. Plasma adiponectin was analyzed with a validated in-house immunoassay. We measured adiponectin in healthy controls (n = 45) and patients with early DMARD-naive RA (n = 40), chronic RA (n = 74), and OA (n = 35). In a Subgroup of patients with chronic RA (n = 3 1), the longitudinal effect of MTX treatment on adiponectin (Week 0 vs Week 28) was investigated.Results. Adiponectin differed significantly between healthy controls (mean 4.8 +/- SD 2.7 mg/l) and the 3 groups, with 8.9 +/- 4.8 mg/l in early RA, 11.6 +/- 5.6 mg/l in chronic RA, and 14.1 +/- 6.4 mg/l in OA. Longitudinally, MTX treatment increased adiponectin significantly from 9.7 +/- 4.5 mg/l at Week 0 to 11.0 +/- 4.5 mg/l at Week 28 in chronic RA. No correlations to disease activity measures were found.Conclusion. Both early DMARD-naive and chronic RA were associated with higher plasma adiponectin compared to healthy controls, but lower plasma adiponectin than OA. Adiponectin increased 13% during MTX treatment. In patients with RA and OA body mass index, age, sex, and disease activity measures failed to explain the findings. (First Release August 15 2009; J Rheumatol 2009;36:1885-91 doi:10.3899/jrheum.080907)