Laurberg Trine Bay, Frystyk Jan, Ellingsen Torkell, Hansen Ib T, Jørgensen Anette, Tarp Ulrik, Hetland Merete Lund, Hørslev-Petersen Kim, Hornung Nete, Poulsen Jørgen Hjelm, Flyvbjerg Allan, Stengaard-Pedersen Kristian
Department of Rheumatology, Aarhus University Hospital, Noerrebrogade 44, Aarhus C, Denmark.
J Rheumatol. 2009 Sep;36(9):1885-91. doi: 10.3899/jrheum.080907. Epub 2009 Aug 14.
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.
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 = 31), the longitudinal effect of MTX treatment on adiponectin (Week 0 vs Week 28) was investigated.
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.
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.
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）是一种炎症活动水平较低的局部关节疾病。脂联素在这些疾病中的致病作用在很大程度上尚不清楚。我们假设：（1）健康对照者与未使用过早期改善病情抗风湿药物（DMARD）的RA患者、慢性RA患者及OA患者的血浆脂联素浓度存在差异；（2）在慢性RA患者接受甲氨蝶呤（MTX）治疗期间可观察到脂联素的变化；（3）脂联素与RA的疾病活动指标相关。
采用经过验证的内部免疫测定法分析血浆脂联素。我们测定了健康对照者（n = 45）、未使用过早期DMARD的RA患者（n = 40）、慢性RA患者（n = 74）及OA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（第0周与第28周）。
健康对照者（平均4.8±标准差2.7mg/L）与这三组患者的脂联素水平存在显著差异，早期RA患者为8.9±4.8mg/L，慢性RA患者为11.6±5.6mg/L，OA患者为14.1±6.4mg/L。纵向来看，在慢性RA患者中，MTX治疗使脂联素水平从第0周的9.7±4.5mg/L显著升高至第28周的11.0±4.5mg/L。未发现脂联素与疾病活动指标相关。
与健康对照者相比，未使用过早期DMARD的RA患者及慢性RA患者的血浆脂联素水平均较高，但低于OA患者。MTX治疗期间脂联素升高了13%。在RA和OA患者中，体重指数、年龄、性别及疾病活动指标均无法解释这些结果。
