Effects of a 6‐month infliximab treatment on plasma levels of leptin and adiponectin in patients with rheumatoid arthritis

Abstract

Patients with rheumatoid arthritis (RA) appear to have increased plasma levels of leptin and adiponectin. These adipokines may be implicated in the pathophysiology of RA. Tumour necrosis factor alpha (TNF-alpha) is a potential modulator of adipokines. The effects of long-term anti-TNF treatment on plasma levels of leptin and adiponectin are not clear. The aim of this study was to assess the effects of 6-month anti-TNF treatment (infliximab) on leptin and adiponectin plasma levels in RA patients. Thirty women with RA were included in the study. Patients with diabetes mellitus, any endocrine disorder or receiving any hypolipidemic or antidiabetic medication were not included. Thirty healthy age- and body mass index-matched women served as controls. Plasma levels of leptin and adiponectin were measured with enzyme immunoassay methods prior to and after the 6-month treatment with infliximab. Mean age and disease duration of patients were 51.8 +/- 14.4 and 12.2 +/- 6.7 years, respectively. Body weight did not change significantly over the 6-month period. Plasma levels of leptin and adiponectin were higher in patients than controls and did not change significantly after 6-month treatment. Interestingly, in the tertile of patients with the highest baseline adiponectin concentrations, adiponectin levels were significantly reduced (P < 0.05). Infliximab treatment did not change plasma levels of leptin and adiponectin after 6-month treatment in the whole study population. However, a reduction of adiponectin levels was observed in patients with higher baseline adiponectin levels.

Subclinical Atherosclerosis in Systemic Autoimmune Disorders

“…In the largest so far study including 97 patients with RA, serum adiponectin was increased after 12 months of anti-TNF treatment (Nishida, Okada et al 2008), an observation also confirmed in smaller reports with the same follow-up period, implying a potential underlying mechanism for CV risk reduction by anti-TNF agents (Komai, Morita et al 2007;Serelis, Kontogianni et al 2008;Engvall, Tengstrand et al 2010). In contrast, with the exception of the Japanese study by Komai et al who revealed increased adiponectin levels as soon as 2 and 6 weeks, no changes or reduction in adiponectin levels have been reported by studies with a follow-up period of 6 months (Derdemezis, Filippatos et al 2009;Popa, Netea et al 2009). …”

Atherosclerosis in rheumatoid arthritis: is it all about inflammation?

“…Some, but not all, studies have found altered circulating levels of adipokines in patients with RA, and associations of adipokine levels with disease activity and with antiTNF treatment have been inconsistent. [60][61][62] Further research is required to elucidate the complex relationship between insulin r esistance, a dipokines and inflammation in RA.…”

Emerging role of leptin in rheumatoid arthritis

“…A study by Derdemezis et al [125] found that anti-TNF treatment effects on cardiovascular disease (CVD) risk were not regulated by changes in leptin levels. Dessein et al also argued that there was no significant relationship between leptin levels and cardiovascular risk in all patients and either female and male or black and white patients with RA.…”