Institute of Experimental Medical Research, Oslo University Hospital Ullevaal, Oslo, Norway
Department of Health Sciences, Oslo New University College, Oslo, Norway.
RMD Open. 2023 Feb;9(1). doi: 10.1136/rmdopen-2022-002815.
In long-term juvenile dermatomyositis (JDM), altered adipose tissue distribution and subclinical cardiac dysfunction have been described. Our aims were to compare adipokine levels in patients with JDM after long-term disease with controls, and explore associations between adipokines and (1) adipose tissue distribution and (2) cardiac function.
The study cohort included 59 patients with JDM (60% female, mean age 25.2 years, mean disease duration 16.9 years), and 59 age/sex-matched controls. Updated Pediatric Rheumatology International Trials Organization criteria for clinically inactive JDM were used to stratify patients into active (JDM-active) or inactive (JDM-inactive) disease groups. Lipodystrophy was clinically assessed in all patients. In all study participants, we measured adipose tissue distribution by dual-energy X-ray absorptiometry and cardiac function by echocardiography. Serum adipokines (adiponectin, apelin-12, lipocalin-2, leptin, visfatin and resistin) were analysed using ELISA.
Patients with JDM had higher leptin levels compared with controls (p≤0.01). In JDM-active, apelin-12 and visfatin were higher compared with JDM-inactive (p≤0.05). In JDM-total and JDM-active, lower adiponectin correlated with lipodystrophy and total fat mass. Also, systolic dysfunction correlated with: lower adiponectin in JDM-total, JDM-inactive and JDM-active, and with lower apelin-12 in JDM-total and JDM-active and resistin in JDM-active (all p≤0.05). Lower adiponectin correlated with diastolic dysfunction in JDM-total and JDM-active.
After long-term disease, leptin levels were unfavourably regulated in patients with JDM compared with controls, and apelin-12 and visfatin in JDM-active versus JDM-inactive. We found associations between adipokines and both adipose tissue distribution and cardiac systolic function in all patients with JDM, which was most prominent in patients with active disease.
在长期青少年皮肌炎（JDM）中，已经描述了脂肪组织分布的改变和亚临床心脏功能障碍。我们的目的是比较 JDM 患者长期疾病后的脂联素水平与对照组，并探讨脂联素与（1）脂肪组织分布和（2）心脏功能之间的关系。
研究队列包括 59 名 JDM 患者（60%为女性，平均年龄 25.2 岁，平均病程 16.9 年）和 59 名年龄/性别匹配的对照组。使用更新的儿科风湿病国际试验组织（PediTRIO）标准来区分有临床活动的 JDM 患者（JDM-活跃）和无临床活动的 JDM 患者（JDM-不活跃）。对所有患者进行临床脂肪营养不良评估。在所有研究参与者中，我们通过双能 X 射线吸收法测量脂肪组织分布，通过超声心动图测量心脏功能。使用 ELISA 分析血清脂联素（脂联素、apelin-12、脂联素-2、瘦素、内脏脂肪素和抵抗素）。
与对照组相比，JDM 患者的瘦素水平更高（p≤0.01）。在 JDM-活跃组中，apelin-12 和内脏脂肪素水平高于 JDM-不活跃组（p≤0.05）。在 JDM-总组和 JDM-活跃组中，较低的脂联素与脂肪营养不良和总脂肪量相关。此外，收缩功能障碍与 JDM-总组、JDM-不活跃组和 JDM-活跃组中较低的脂联素以及 JDM-总组和 JDM-活跃组中较低的 apelin-12 和 JDM-活跃组中抵抗素相关（所有 p≤0.05）。在 JDM-总组和 JDM-活跃组中，较低的脂联素与舒张功能障碍相关。
与对照组相比，长期疾病后 JDM 患者的瘦素水平调节不良，而 JDM-活跃患者的 apelin-12 和内脏脂肪素水平升高。我们发现所有 JDM 患者的脂联素与脂肪组织分布和心脏收缩功能之间存在关联，在活跃疾病患者中最为明显。
