Department of Internal Medicine, Division of Rheumatology, Eskişehir Osmangazi University, Eskişehir, Turkey.
J Clin Rheumatol. 2011 Jan;17(1):14-7. doi: 10.1097/RHU.0b013e318204a587.
Adiponectin is an adipocyte-derived adipokine with immunosuppressive and anti-inflammatory properties. It also decreases expression of adhesion molecules. In terms of its relationship with acute-phase reactants, there are conflicting results in patients with rheumatoid arthritis (RA).
The objectives of this study were to evaluate the levels of adiponectin in RA patients before and after the treatment with disease-modifying antirheumatic drugs (DMARDs) and to evaluate whether there is a correlation between adiponectin levels and disease activity and acute-phase-response reactants (APRRs).
Serum adiponectin levels, APRRs, total and high-density lipoprotein cholesterol (HDL-C), body mass index, and body fat mass were measured in 27 patients with RA before and after the treatment with DMARDs plus prednisolone. An inclusion criterion for RA patients was to be DMARD naive for at least 6 months or to have been newly diagnosed with RA. Twenty patients with osteoarthritis were included in this study as a disease control.
No significant difference was found between RA and osteoarthritis group in terms of baseline adiponectin level. Mean adiponectin level and mean HDL-C level increased significantly compared with mean baseline level after the treatment with DMARDs plus prednisolone (10 [SD, 4.9] vs. 13.9 [SD, 8.7] μg/mL; P < 0.001; 56.8 [SD, 19] vs. 65 [SD, 18] mg/dL, P < 0.004, respectively). APRRs and the 28-joint-count disease activity score decreased significantly at the end of the 3 months of therapy. The adiponectin levels tended to be negatively correlated with acute-phase reactants and disease activity, although no changes were significant. There was a positive correlation between HDL-C and adiponectin levels at 3 month (r = 0.53, P < 0.001). No correlation was found between erythrocyte sedimentation rate and adiponectin levels both at baseline and at 3 months.
Adiponectin levels can be modified by effective treatment of rheumatoid arthritis. This suggests that active inflammation may decrease serum adiponectin levels. In consideration of the antiatherogenic and anti-inflammatory features of adiponectin, increased adiponectin levels in patients with RA may result in a more favorable cardiovascular profile.
脂联素是一种脂肪细胞衍生的脂肪因子，具有免疫抑制和抗炎特性。它还能降低黏附分子的表达。就其与急性期反应物的关系而言，类风湿关节炎（RA）患者的结果存在冲突。
本研究旨在评估接受疾病修饰抗风湿药物（DMARDs）治疗前后 RA 患者的脂联素水平，并评估脂联素水平与疾病活动度和急性期反应物（APRRs）之间是否存在相关性。
在接受 DMARDs 加泼尼松龙治疗前后，测量 27 例 RA 患者的血清脂联素水平、APRRs、总胆固醇和高密度脂蛋白胆固醇（HDL-C）、体重指数和体脂肪量。RA 患者的纳入标准为至少 6 个月 DMARD 初治或新诊断为 RA。20 例骨关节炎患者作为疾病对照组纳入本研究。
RA 组和骨关节炎组在基线脂联素水平方面无显著差异。与 DMARDs 加泼尼松龙治疗前的平均基线水平相比，治疗后平均脂联素水平和平均 HDL-C 水平显著升高（10[标准差，4.9] vs. 13.9[标准差，8.7]μg/mL；P<0.001；56.8[标准差，19] vs. 65[标准差，18]mg/dL，P<0.004）。治疗 3 个月后，APRRs 和 28 关节疾病活动评分显著下降。尽管没有明显变化，但脂联素水平与急性期反应物和疾病活动度呈负相关趋势。在治疗 3 个月时，HDL-C 与脂联素水平呈正相关（r=0.53，P<0.001）。在基线和 3 个月时，红细胞沉降率与脂联素水平均无相关性。
脂联素水平可通过类风湿关节炎的有效治疗得到改善。这表明，活性炎症可能会降低血清脂联素水平。考虑到脂联素的抗动脉粥样硬化和抗炎特性，RA 患者的脂联素水平升高可能会导致更有利的心血管状况。
