RESEARCH - Adiponectin is a mediator of the inverse association of adiposity with radiographic damage in RA

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Arthritis Rheum. 2009 Sep 15;61(9):1248-56.

Adiponectin is a mediator of the inverse association of adiposity with

radiographic damage in rheumatoid arthritis.

Giles JT, M, Bingham CO 3rd, WM Jr, Bathon JM.

The s Hopkins University School of Medicine, Baltimore, land.

OBJECTIVE: Recent reports have suggested that increasing adiposity may

protect against radiographic damage in rheumatoid arthritis (RA). We

explored the role of serum adipokines (adiponectin, resistin, and

leptin) in mediating this association.

METHODS: Patients with RA underwent total-body dual x-ray

absorptiometry for measurement of total and regional body fat and lean

mass, abdominal computed tomography for measurement of visceral fat

area, and radiographs of the hands and feet scored according to the

modified Sharp/van der Heijde (SHS) method. Serum levels of adipokines

were measured and cross-sectional associations with radiographic

damage were explored, adjusting for pertinent confounders. The

associations of measures of adiposity with radiographic damage were

explored with the introduction of adipokines into multivariable

modeling as potential mediators.

RESULTS: Among the 197 patients studied, adiponectin demonstrated a

strong association with radiographic damage, with the log SHS score

increasing by 0.40 units for each log unit increase in adiponectin (P

= 0.001) after adjusting for pertinent predictors of radiographic

damage. Adiponectin independently accounted for 6.1% of the

explainable variability in SHS score, a proportion comparable with

rheumatoid factor, and greater than HLA-DRB1 shared epitope alleles or

C-reactive protein levels. Resistin and leptin were not associated

with radiographic damage in adjusted models. An inverse association

between visceral fat area and radiographic damage was attenuated when

adiponectin was modeled as a mediator. The association of adiponectin

with radiographic damage was stronger in patients with longer disease

duration.

CONCLUSION: Adiponectin may represent a mechanistic link between low

adiposity and increased radiographic damage in RA. Adiponectin

modulation may represent a novel strategy for attenuating articular

damage.

PMID: 19714593

http://www.ncbi.nlm.nih.gov/pubmed/19714593

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