Adiponectin is negatively associated with disease activity and Sharp score in treatment-naïve Han Chinese rheumatoid arthritis patients

Abstract

The association and potential role of the protein hormone adiponectin in autoimmune diseases causing musculoskeletal disorders, including rheumatoid arthritis (RA), are controversial. Conflicting results may arise from the influences of confounding factors linked to genetic backgrounds, disease stage, disease-modifying anti-rheumatic drugs and patients’ metabolic characteristics. Here, we examined serum level of adiponectin and its relationship with disease activity score 28 with erythrocytes sedimentation rate (DAS28[ESR]) and Sharp score in a treatment-naïve Han Chinese RA population. This cross-sectional study enrolled 125 RA patients. Serum level of total adiponectin was assessed by enzyme-linked immunosorbent assay (ELISA). Other important clinical and laboratory parameters were collected from the hospital database. DAS28(ESR) was calculated according to the equation previously published. Sharp score was evaluated based on hands radiographs by an independent radiologist. The correlation between serum adiponectin level and DAS28(ESR) or the Sharp score was investigated by univariate and multivariable linear regression analyses, respectively. Multiple imputation by chained equations was used to account for missing data. Univariate analyses showed a significant positive correlation between DAS28(ESR) and age or C-reactive protein (CRP) (both p = 0.003), while serum adiponectin level was negatively correlated with DAS28(ESR) (p = 0.015). The negative correlation between adiponectin level and DAS28(ESR) remained true in multivariable analyses adjusted for confounders. In addition, the univariate analyses revealed positive correlations of Sharp score to disease duration (p < 0.001), CRP (p = 0.023) and ESR (p < 0.001). In the multivariable model adjusted for confounders, adiponectin was negatively correlated with Sharp score (p = 0.013). In this single-institution cross-sectional study, serum adiponectin level in treatment-naive RA patients is negatively correlated with DAS28(ESR) and the Sharp score after adjustment for prominent identified confounders. Serum adiponectin may be potentially useful for assessing disease activity and radiographic progression of RA.

Atherothrombotic Risk Factors in Patients With Rheumatoid Arthritis

“…Studies have indicated that adiponectin exhibits antidiabetic and vasculo-protective effects [ 37 ]. Inverse or favorable and direct or paradoxically unfavorable associations of adiponectin concentrations were observed in many studies attributing to the metabolic risk factors in RA [ 38 - 40 ]. In our study adiponectin was found to be decreased in RA patients compared to controls.…”

Adiponectin Is a Component of the Inflammatory Cascade in Rheumatoid Arthritis

“…In addition, studies suggest that in newly-diagnosed RA, adiponectin exerts mainly anti-inflammatory effects, but pro-inflammatory effects of adiponectin are observed in patients with advanced disease. Chen et al have shown a negative correlation between plasma adiponectin levels and disease activity parameters in newly diagnosed RA patients [ 43 ], while in studies including patients with advanced disease, a positive correlation of adiponectin with disease process activity parameters was observed [ 22 ].…”

Adipokines in Rheumatoid Arthritis: Emerging Biomarkers and Therapeutic Targets

“…Several investigations [200,[260][261][262]265,272,275,277,278] have found a positive correlation between adiponectin serum levels and disease activity or radiographic progression. Nevertheless, this association is not universally acknowledged, as other studies have produced contradictory findings [202,219,223,258,268,279]. Baker et al [276] recently found that adiponectin levels were strongly associated with radiographic damage, seropositivity, longer disease duration, prednisone use, and circulating inflammatory cytokines in people with rheumatoid arthritis.…”