Novella-Navarro Marta, González-Sánchez Laura, Hernández-Breijo Borja, Pérez De Diego Rebeca, Sánchez-Corral Pilar, López-Trascasa Margarita, Miranda-Carús Maria-Eugenia, Villalba Alejandro, Balsa Alejandro, De Miguel Eugenio, Plasencia-Rodríguez Chamaida, Corvillo Fernando
Rheumatology Department, Hospital Universitario La Paz, Madrid, Spain.
Immuno-Rheumatology Investigation Group, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain.
Front Immunol. 2025 Aug 6;16:1636158. doi: 10.3389/fimmu.2025.1636158. eCollection 2025.
Rheumatoid arthritis (RA) and axial spondyloarthritis (axSpA) are the most common rheumatic diseases (RDs). They are characterised by chronic inflammation of the joints and musculoskeletal components. Adipose tissue releases adipokines that regulate numerous biological processes, including inflammation, thus stabilising the relationship between RDs and adipokines, such as adiponectin and leptin. The correlation between these adipokines and RA highlights a possible role of other adipokines in RDs. Therefore, we decided to analyse the role of the adipokine adipsin in the context of RDs. Adipsin levels were measured in serum from 233 patients (66 early-RA, 98 established-RA, and 69 axSpA) and 88 healthy controls (HCs). Associations between adipsin and clinical or demographic variables were assessed using univariate and multivariate regression models. The diagnostic utility of adipsin was evaluated using ROC curve analysis. Our study revealed that adipsin concentrations were significantly higher in both early-RA and established-RA patients than in axSpa and in HCs. No significant differences were found between axSpA and HCs. In early-RA, female sex and prednisone use were independently associated with higher adipsin levels. In established-RA, age and disease duration showed a positive association with adipsin concentrations. In axSpA, disease duration and CRP correlated with adipsin levels, but no consistent associations were observed for BMI or HLA-B27 status. ROC analysis revealed good discriminatory capacity of adipsin to differentiate early-RA from HCs (AUC = 0.82; optimal cut-off: 1.325 µg/mL). We provide evidence supporting the involvement of adipsin in the pathophysiology of RA and highlight its value as a new potential biomarker.
类风湿关节炎（RA）和轴性脊柱关节炎（axSpA）是最常见的风湿性疾病（RDs）。它们的特征是关节和肌肉骨骼成分的慢性炎症。脂肪组织释放调节多种生物过程（包括炎症）的脂肪因子，从而稳定RDs与脂联素和瘦素等脂肪因子之间的关系。这些脂肪因子与RA之间的相关性凸显了其他脂肪因子在RDs中的可能作用。因此，我们决定分析脂肪因子脂肪酶在RDs背景下的作用。测量了233例患者（66例早期RA、98例确诊RA和69例axSpA）和88例健康对照（HCs）血清中的脂肪酶水平。使用单变量和多变量回归模型评估脂肪酶与临床或人口统计学变量之间的关联。使用ROC曲线分析评估脂肪酶的诊断效用。我们的研究表明，早期RA和确诊RA患者的脂肪酶浓度均显著高于axSpA患者和HCs。axSpA患者和HCs之间未发现显著差异。在早期RA中，女性和使用泼尼松与较高的脂肪酶水平独立相关。在确诊RA中，年龄和病程与脂肪酶浓度呈正相关。在axSpA中，病程和CRP与脂肪酶水平相关，但未观察到BMI或HLA - B27状态的一致关联。ROC分析显示脂肪酶对区分早期RA和HCs具有良好的辨别能力（AUC = 0.82；最佳截断值：1.325 µg/mL）。我们提供了支持脂肪酶参与RA病理生理学的证据，并强调了其作为一种新的潜在生物标志物的价值。
