Vasileiadis Georgios K, Zhang Yuan, Fatima Tahzeeb, van Vollenhoven Ronald, Lampa Jon, Gudbjornsson Bjorn, Haavardsholm Espen A, Nordström Dan, Grondal Gerdur, Hørslev-Petersen Kim, Lend Kristina, Heiberg Marte S, Hetland Merete Lund, Nurmohamed Michael, Uhlig Till, Sokka-Isler Tuulikki, Rudin Anna, Maglio Cristina
University of Gothenburg, Gothenburg, Sweden.
Karolinska University Hospital, Stockholm, Sweden, and Amsterdam University Medical Centers, Amsterdam, The Netherlands.
ACR Open Rheumatol. 2025 Jan;7(1):e11756. doi: 10.1002/acr2.11756. Epub 2024 Nov 4.
The objective of this study was to determine if baseline adiponectin, leptin, and resistin levels are associated with response to antirheumatic treatment in early rheumatoid arthritis (RA).
This study included 341 participants of the Nordic Rheumatic Diseases Strategy Trials and Registries trial with untreated early RA, randomized at baseline into four treatment arms: methotrexate combined with (1) prednisolone, (2) certolizumab, (3) abatacept, or (4) tocilizumab. Follow-up was up to 48 weeks. Adipokines were measured in plasma at baseline with enzyme-linked immunosorbent assay. The primary outcome for this report was the difference in remission (Clinical Disease Activity Index [CDAI] ≤2.8) over 48 weeks stratified by median adipokine levels.
At baseline, levels of adiponectin and leptin were not associated with markers of RA activity, whereas participants with higher resistin levels had higher C-reactive protein (CRP) levels, swollen joint count, and Disease Activity Score in 28 joints based on CRP compared to participants with lower resistin. Overall, participants with baseline adipokine levels above the median and those with adipokine levels below the median had similar mean CDAI and changes in CDAI throughout follow-up for up to 48 weeks. Adjusted Cox proportional hazards models did not show any effect of baseline adiponectin, leptin, and resistin levels on the likelihood of achieving CDAI remission (adiponectin: hazard ratio [HR] 1.08, 95% confidence interval [CI] 0.80-1.45, P = 0.62; leptin: HR 0.89, 95% CI 0.64-1.26, P = 0.52; resistin: HR 0.86, 95% CI 0.65-1.13, P = 0.26).
Baseline adiponectin, leptin, and resistin levels are not associated with the likelihood of achieving CDAI remission over 48 weeks of treatment in a large cohort of people with untreated early RA.
本研究旨在确定基线脂联素、瘦素和抵抗素水平是否与早期类风湿关节炎（RA）抗风湿治疗的反应相关。
本研究纳入了北欧风湿性疾病战略试验与注册研究中341例未经治疗的早期RA参与者，在基线时随机分为四个治疗组：甲氨蝶呤联合（1）泼尼松龙、（2）赛妥珠单抗、（3）阿巴西普或（4）托珠单抗。随访长达48周。在基线时采用酶联免疫吸附测定法检测血浆中的脂肪因子。本报告的主要结局是根据脂肪因子水平中位数分层的48周内缓解（临床疾病活动指数[CDAI]≤2.8）差异。
在基线时，脂联素和瘦素水平与RA活动指标无关，而抵抗素水平较高的参与者与抵抗素水平较低的参与者相比，其C反应蛋白（CRP）水平、肿胀关节计数以及基于CRP的28个关节疾病活动评分更高。总体而言，基线脂肪因子水平高于中位数的参与者和低于中位数的参与者在长达48周的随访期间平均CDAI及CDAI变化相似。校正后的Cox比例风险模型未显示基线脂联素、瘦素和抵抗素水平对实现CDAI缓解的可能性有任何影响（脂联素：风险比[HR]1.08，95%置信区间[CI]0.80 - 1.45，P = 0.62；瘦素：HR 0.89，95%CI 0.64 - 1.26，P = 0.52；抵抗素：HR 0.86，95%CI 0.65 - 1.13，P = 0.26）。
在一大群未经治疗的早期RA患者中，基线脂联素、瘦素和抵抗素水平与48周治疗期间实现CDAI缓解的可能性无关。
