Association of adipokines with rheumatic disease activity indexes and periodontal disease in patients with early rheumatoid arthritis and their first‐degree relatives

Abstract

Objective:To evaluate the adipokine levels in early rheumatoid arthritis (eRA) and first-degree relatives (FDR) of patients with RA and establish their association with rheumatic disease activity and periodontal variables. Method:A cross-sectional study with eRA patients, FDR and a healthy population.Adipokine levels, clinical, joint radiological indexes and periodontal variables were evaluated. A descriptive, bivariate analysis was performed based on the adipokine levels by χ 2 , Fisher's test and Mann-Whitney U test. A logistic regression was made for associations. Results:High leptin levels were associated with the diagnosis of eRA (odds ratio[OR] = 2.79; 95% CI 1.54-5.07). Early rheumatoid arthritis with high adiponectin levels was less likely to have Multidimensional Health Assessment Questionnaire score >3, body mass index (BMI) >25 and Routine Assessment of Patient Index Data 3 score >12 (OR = 0.16; 95% CI 0.03-0.72). Early rheumatoid arthritis was more likely to present high leptin and interleukin (IL)6 levels with low adiponectin simultaneously (OR = 5.03; 95% CI 1.05-24.0). High leptin levels were associated with the FDR adjusted for IgG2 Porphyromonas gingivalis, swollen joints, P gingivalis and low IL6 (OR = 2.57; 95% CI 1.14-5.95). Conclusion:High adipokine levels in eRA may modulate the disease activity. Having more than 1 adipokine at high serum levels is associated with increased disability, disease activity and BMI, indicating that RA is controlled by adiponectin levels in the early stages of the disease. High leptin levels, presence of P gingivalis and swollen joints may be the factors associated with the development of RA in FDR. K E Y W O R D Sadipokines, adiponectin, leptin, periodontitis, rheumatoid arthritis | 1991 CHAPARRO-SANABRIA et Al.

Is there a bidirectional association between rheumatoid arthritis and periodontitis? A systematic review and meta-analysis

“…Lately, evidence-based reviews have showed moderate evidence that RA patients have increased risk of developing PD (43,66) and more missing teeth and higher levels of CAL (63) compared to general population In addition, positive associations between various RA biomarkers and PD, such as Interleukin-21, Resistin and Adipokines have been established (67)(68)(69). Also, it has been confirmed that nonsurgical periodontal treatment has beneficial effects on RA periodontal patients by improving clinical and inflammatory parameters (47,48).…”

Risk Factors for Developing Rheumatoid Arthritis in Patients With Undifferentiated Arthritis and Inflammatory Arthralgia

“…However, in another case-control study, that also evaluated the influence of obesity in patients with pre-arthritis vs. controls, Tedeschi et al, correlated BMI and ACPA positivity with the development of RA, especially in women. These results suggest that ACPA and obesity can act synergistically, constituting a risk factor for the development of RA, as well as Chaparro-Sanabria et al (105). These results also suggest that women with both risk factors are likely to progress to clinical development of RA most rapidly of any population (106).…”

A Roadmap for Investigating Preclinical Autoimmunity Using Patient-Oriented and Epidemiologic Study Designs: Example of Rheumatoid Arthritis

“…The pathogen, itself, is not a marker of periodontitis, however the presence of “antibodies against P. gingivalis before the onset of RA symptoms are associated with ACPAs and RA disease activity markers” ( 118 ). Swollen joints were also suggested as potentially relevant identifiers associated with RA development in FDRs ( 118 ). Another study using this same subject population included 124 FDRs ( 117 ).…”

“…Investigators utilized this cohort to examine adipokine association and periodontal disease in individuals diagnosed with early RA and their FDRs ( 118 ). The authors found that high leptin, presence of Porphyromonas gingivalis, a pathogen with an enzyme that is able cause citrullination in the periodontium ( 118 ).…”