Adipokines, inflammation, insulin resistance, and carotid atherosclerosis in patients with rheumatoid arthritis.
BACKGROUND
Cardiovascular (CV) morbidity and mortality are increased in patients with rheumatoid arthritis (RA). Inflammation is thought to be an important factor in accelerated atherosclerosis in RA, whereas insulin resistance is a known risk factor for atherosclerosis in RA. We hypothesised that adipokines could be a link between inflammation, insulin resistance, and atherosclerosis in RA.


METHODS
The common carotid artery (CCA) intima-media thickness (IMT), CCA resistive index (RI), and carotid plaques were measured by ultrasonography in 192 patients with RA. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). Serum adiponectin, leptin, resistin, tumor necrosis factor-α, and interleukin (IL)-6 concentrations were determined.


RESULTS
The CCA RI was associated with CCA IMT and the estimated total plaque volume after adjustment for conventional CV risk factors. Among adipokines, resistin and IL-6 were correlated with inflammatory parameters. Leptin and leptin:adiponectin (L:A) ratio were correlated with metabolic risk factors, including HOMA-IR. And L:A ratio was related to the CCA RI after adjustment for conventional and nonconventional CV risk factors, including HOMA-IR, erythrocyte sedimentation rate and C-reactive protein.


CONCLUSIONS
L:A ratio was associated with HOMA-IR and carotid RI. L:A ratio might be an independent factor for predicting cardiovascular risk in patients with RA.
Yoon
Y
Kang
Hee-Jin
HJ
Park
Mi-I
MI
Kang
Hyang-Sun
HS
Lee
Sang-Won
SW
Lee
Soo-Kon
SK
Lee
Yong-Beom
YB
Park
D054392:Adipokines / Q000097:blood*; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000150:complications* / Q000473:pathology; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
D054392:Adipokines