Adipocytokines and Associations With Abnormal Body Composition in Rheumatoid Arthritis

Abstract

Objective. We determined associations between adipokines and abnormal body composition in patients with rheumatoid arthritis (RA).Methods. Combining data from three RA cohorts, whole-body dual-energy absorptiometry measures of appendicular lean mass and fat mass indices were converted to age-, sex-, and race-and ethnicity-specific Z scores. Lean mass relative to fat mass was determined based on prior methods. Independent associations between body composition profiles and circulating levels of adiponectin, leptin, and fibroblast growth factor (FGF)-21 were assessed using linear and logistic regression models adjusting for demographic characteristics and study cohort. We also determined the improvement in the area under the curve (AUC) for prediction of low lean mass when adipokines were added to predictive models that included clinical factors such as demographic characteristics, study, and body mass index (BMI).Results. Among 419 participants, older age was associated with higher levels of all adipokines, whereas higher C-reactive protein level was associated with lower adiponectin levels and higher FGF-21 levels. Greater fat mass was strongly associated with lower adiponectin levels and higher leptin and FGF-21 levels. Higher levels of adiponectin, leptin, and FGF-21 were independently associated with low lean mass. The addition of adiponectin and leptin levels to regression models improved prediction of low lean mass when combined with demographic characteristics, study, and BMI (AUC 0.75 vs. 0.66).Conclusion. Adipokines are associated with both excess adiposity and low lean mass in patients with RA. Improvements in the prediction of body composition abnormalities suggest that laboratory screening could help identify patients with altered body composition who may be at greater risk of adverse outcomes.

Circulating Adipokines and Associations With Incident Cardiovascular Disease in Rheumatoid Arthritis

“…A recent study found a positive association between adiponectin and disease activity in RA patients with low body weight, perhaps due to relationships between inflammatory cytokines, weight loss, and adiponectin production (43). Our group has previously demonstrated associations between adipokines and sarcopenia in RA (22). Our findings, in the context of these prior observations, suggest that adiponectin may serve as a marker of chronic illness and disease severity, helping to predict hospitalization and death, but not necessarily initial acute events such as coronary events, stroke, or VTE.…”

Lower body mass and lower adiposity are associated with differential responses to two treatment strategies for rheumatoid arthritis

“…We previously showed that adipokine levels at enrolment in a clinical registry predicted a lower likelihood of achieving LDA over time 12. Adipokines have also been associated with systemic inflammation, sarcopenia and mortality in patients with RA 11 28. For example, in one study, those with the highest levels of adiponectin also had higher levels of TNF, IL-6, IFN-γ, and IL-1β 11.…”

Association Between the Quality of Life Domains with Anthropometric and Adiposity Indices in Rheumatoid Arthritis: A Cross-Sectional Study from a Single Centre in Erbil-Iraq

“…This observation confirmed other studies that showed body fat composition may be consider as an independent risk factor for RA, and that the levels of adipocytokines are significantly elevated in RA. 38 , 39 Table 6 shows that the WWI (by which the waist circumference was adjusted according on the patient’s weight) was not statistically linked with QoL impairment. The interpretation of this data is that WC is not a major factor related with QoL.…”