Adipozytokine bei Rheumatoider Arthritis und Adipositas

Abstract

In obese rheumatoid arthritis (RA) patients inflammatory mechanisms and cardiovascular secondary disorders are possibly related to changed expression of adipocytokines. Various adipocytokines and inflammatory parameters were examined in 112 patients (23.2% men; 76.8% women) suffering from RA: leptin, adiponectin, visfatin, sCD40 L, CRP, and ESR. Average BMI was 27.6 (+/-5.6). Leptin and BMI as well as visfatin and BMI correlated positively, BMI and adiponectin, however, showed a negative correlation. Significant differences between normal-weight and obese RA patients were found in both leptin and adiponectin measurements. Visfatin showed a positive correlation with CRP; sCD40 ligand which is a marker for increased T-cell activity correlated with CRP and ESR. Patients with low adiponectin levels (<10 microg/ml) more often suffered from cardiovascular diseases (28.6%) than those with enhanced adiponectin (14.3%). Increased pro-inflammatory leptin and decreased anti-inflammatory adiponectin in obese RA patients can be associated with RA activity and enhanced cardiovascular risk.

Body composition and serum levels of adiponectin, vascular endothelial growth factor, and interleukin-6 in patients with rheumatoid arthritis

“…On the other hand, some authors have reported high adiponectin levels correlating with disease activity in general population of RA patients (30). Only one study (19) demonstrated hypoadiponectinemia in patients with RA and obesity, which is similar to our data. In our study, serum concentration of adiponectin increased in RA patients with normal BMI and underweight patients and decreased in obesity/overweight patients.…”

“…Increased production of serum adiponectin and correlation of adiponectin with proinflammatory cytokines was found in RА patients with normal body weight (17,18), but only one study investigated the production of serum adiponectin in RA patients with obesity (19). Also, most studies identified increased serum concentrations of IL-6 and VEGF in RA patients with normal body weight (20-22), without studying the patients with reduced or increased BMI.…”

Nicotinamide Phosphoribosyltransferase in Rheumatoid Arthritis

“…Matsui et al [25] detected elevated Nampt mRNA expression in synovial tissue, peripheral blood mononuclear cells (PBMCs), and peripheral blood granulocytes (PBGs) isolated from RA patients compared to healthy controls. Subsequent surveys [17,[26][27][28][29] have verified that expression of Nampt in serum, synovial fluid, and synovial tissue is elevated in patients with RA. In a large survey of 167 RA patients and 91 control subjects by Rho et al [26] elevated levels of Nampt correlated with both radiological joint destruction and mediators of inflammation.…”

“…Nampt expression is up-regulated in a variety of acute and chronic inflammatory diseases including acute lung injury [14], sepsis [15], inflammatory bowel disease, [16,17] atherosclerosis, [18,19] osteoarthritis [20][21][22] and rheumatoid arthritis [17,[23][24][25][26][27][28][29][30]. Recent findings have demonstrated that targeted inhibition of Nampt attenuates the inflammatory process and disease progression in mouse models of arthritis [31,32], suggesting that Nampt plays a key role in the pathogenesis of RA.…”

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

“…Leptin is essential for the regulation of appetite and body weight, as well as the modulation of immune responses (Rho, Chung et al 2010). While resistin and visfatin are associated with inflammation, insulin resistance and subclinical atherosclerosis, adiponectin is mainly antiinflammatory, and inversely associated with obesity, insulin resistance, CRP and CV risk (Fagerer and Kullich 2010;Yoshino, Kusunoki et al 2011). In patients with RA, higher levels of adipocytokines have been detected compared to control subjects.…”