title: Adipocytokines in primary antiphospholipid syndrome: potential markers of low-grade inflammation, insulin resistance and metabolic syndrome.
abstract: OBJECTIVE
  This study was undertaken to evaluate a possible association of adipocytokines with metabolic syndrome (MetS), inflammation and other cardiovascular risk factors in primary antiphospholipid syndrome (PAPS).
  
  
  METHODS
  Fifty-six PAPS patients and 72 controls were included. Adiponectin, leptin, visfatin, resistin, plasminogen activator inhibitor-1 (PAI-1), lipoprotein (a), glucose, ESR, CRP, uric acid and lipid profiles were measured. The presence of MetS was determined as defined by the International Diabetes Federation (IDF), and insulin resistance was rated using the homeostasis model assessment (HOMA) index.
  
  
  RESULTS
  Concentrations of leptin were higher [21.5 (12.9-45.7) ng/mL] in PAPS patients than in the controls [12.1 (6.9-26.8) ng/mL), p=0.001]. In PAPS patients, leptin and PAI-1 levels were positively correlated with BMI (r=0.61 and 0.29), HOMA-IR (r=0.71 and 0.28) and CRP (r=0.32 and 0.36). Adiponectin levels were negatively correlated with BMI (r=-0.28), triglycerides (r=-0.43) and HOMA-IR (r=-0.36) and positively correlated with HDL-c (r=0.37) and anti-β2GPI IgG (r=0.31). The presence of MetS in PAPS patients was associated with higher levels of leptin (p=0.002) and PAI-1 (p=0.03) levels and lower levels of adiponectin (p=0.042). Variables that independently influenced the adiponectin concentration were the triglyceride levels (p<0.001), VLDL-c (P=0.002) and anti-β2GPI IgG (p=0.042); the leptin levels were BMI (p<0.001), glucose (p=0.046), HOMA-IR (p<0.001) and ESR (p=0.006); and the PAI-1 levels were CRP (p=0.013) and MetS (p=0.048).
  
  
  CONCLUSIONS
  This study provides evidence that adipocytokines may be involved in low-grade inflammation, insulin resistance and MetS in PAPS patients.
authors.affiliation: Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo-SP, Brazil. carlosewerton@hotmail.com
authors.forename: Carlos E M
authors.initials: CE
authors.lastname: Rodrigues
authors.forename: Margarete B
authors.initials: MB
authors.lastname: Vendramini
authors.forename: Cleonice
authors.initials: C
authors.lastname: Bueno
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfá
authors.forename: Jozélio F
authors.initials: JF
authors.lastname: de Carvalho
mesh_terms: D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood*; D007333:Insulin Resistance; D020738:Leptin / Q000097:blood; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology; D008875:Middle Aged; D015999:Multivariate Analysis; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D052243:Resistin / Q000097:blood
chemical_list: C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D020738:Leptin; D008055:Lipids; D017395:Plasminogen Activator Inhibitor 1; C499624:RETN protein, human; D052243:Resistin; C051321:SERPINE1 protein, human; D054409:Nicotinamide Phosphoribosyltransferase; C085455:nicotinamide phosphoribosyltransferase, human