Saglik Bilimleri University, Izmir Tepecik Training and Research Hospital, Department of Rheumatology, Izmir, Turkey.
Dokuz Eylul University School of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Izmir, Turkey.
Arch Med Res. 2021 Jul;52(5):544-553. doi: 10.1016/j.arcmed.2021.02.002. Epub 2021 Feb 23.
Previous studies have reported a link between metabolic parameters and disease activity in rheumatoid arthritis (RA), although the evidence is limited in early RA. We aimed to investigate the relationship between disease activity and adipocytokine levels in subjects with early RA.
Forty-seven patients with early RA (symptom duration ≤12 months) were enrolled. Disease activity was determined by DAS28-CRP. Patients were treated with DMARDs according to the EULAR recommendations. Subjects were tested before and five months after treatment.
Early RA patients with high disease activity (DAS28-CRP > 4.9) had greater BMI (31.2 ± 6.8 kg/m vs. 26.7 ± 4.1 kg/m; p = 0.006) and higher leptin levels (14.62 ± 15.60 ng/mL vs. 7.82 ± 8.00 ng/mL; p = 0.048). Levels of other adipocytokines were not significantly different. Leptin levels were similar in subjects with mild/moderate disease activity and controls. DAS28-CRP was correlated with leptin (r = 0.303, p = 0.039). Leptin levels decreased significantly after treatment (from 10.86 ± 12.34 ng/mL to 9.22 ± 9.29 ng/mL; p = 0.047) along with insulin levels (from 13.68 ± 21.90 mU/L to 7.09 ± 4.72 mU/L; p = 0.010) and HOMA-IR (from 4.39 ± 9.53 to 1.70 ± 1.38; p = 0.012). HDL cholesterol levels increased (from 41 ± 10 mg/dL48 ± 10 mg/dL; p <0.001).
Leptin levels were associated with disease activity in patients with early RA and these levels decreased after treatment with DMARDs. Further research is needed to elicit leptin's role to regulate disease activity in early RA.
先前的研究报告称代谢参数与类风湿关节炎（RA）的疾病活动度之间存在关联，尽管早期 RA 的证据有限。我们旨在研究早期 RA 患者疾病活动度与脂肪细胞因子水平之间的关系。
纳入 47 例早期 RA（症状持续时间≤12 个月）患者。采用 DAS28-CRP 评估疾病活动度。根据 EULAR 建议，用 DMARDs 对患者进行治疗。在治疗前和治疗后 5 个月对患者进行检测。
疾病活动度高（DAS28-CRP＞4.9）的早期 RA 患者 BMI 更高（31.2±6.8kg/m2 vs. 26.7±4.1kg/m2；p=0.006），瘦素水平更高（14.62±15.60ng/mL vs. 7.82±8.00ng/mL；p=0.048）。其他脂肪细胞因子水平无显著差异。疾病活动度较轻/中度的患者和对照组的瘦素水平相似。DAS28-CRP 与瘦素呈正相关（r=0.303，p=0.039）。治疗后，瘦素水平显著下降（从 10.86±12.34ng/mL 降至 9.22±9.29ng/mL；p=0.047），同时胰岛素水平（从 13.68±21.90mU/L 降至 7.09±4.72mU/L；p=0.010）和 HOMA-IR（从 4.39±9.53 降至 1.70±1.38；p=0.012）也下降。HDL 胆固醇水平升高（从 41±10mg/dL 升至 48±10mg/dL；p＜0.001）。
瘦素水平与早期 RA 患者的疾病活动度相关，且在用 DMARDs 治疗后下降。需要进一步研究以确定瘦素在调节早期 RA 疾病活动度方面的作用。
