title: Serum adipokines and adipose tissue distribution in rheumatoid arthritis and ankylosing spondylitis. A comparative study.
abstract: Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are inflammatory rheumatic diseases that may modify body composition. Adipose tissue has the ability to release a wide range of products involved in physiologic functions, but also in various pathological processes, including the inflammatory/immune response. RA and AS are both associated with the development of cardiovascular complications. It is has been established that central/abdominal, and particularly intra-abdominal or visceral adiposity is closely linked to cardiovascular events. Thus, in this study, we aimed to evaluate the body composition of patients with RA or AS compared to healthy controls (HC), with a special emphasis on the visceral region. In parallel, we measured adipose products or adipokines, namely leptin, adiponectin and its high molecular weight (HMW) isoform, resistin, and ghrelin, a gastric peptide that plays a role in energetic balance. The homeostasis model assessment for insulin resistance (HOMA-IR) and atherogenic index were used to evaluate cardiovascular risk. One hundred and twelve subjects were enrolled (30 patients with RA, 31 with AS, and 51 HC). Body composition was measured using dual-energy X-ray absorptiometry to determine total fat mass and lean mass, adiposity, fat in the android and gynoid regions, and visceral fat. Patients and HC did not differ in terms of body mass index. On the contrary, adiposity was increased in RA (p = 0.01) while visceral fat was also increased, but only in women (p = 0.01). Patients with AS tended to have lower total fat mass (p = 0.07) and higher lean mass compared to HC (p = 0.07). Leptin and leptin/fat mass were decreased in male patients with AS (p < 0.01), while total adiponectin and the ratio of HMW to total adiponectin were both increased in RA (p < 0.01). There were no changes in serum resistin and ghrelin in any group of patients. HOMA-IR and the atherogenic index were not modified in RA and AS. These results confirm that body composition was altered in RA and AS, affecting distinct soft tissue compartments. The effect of the increased visceral adipose tissue on cardiovascular risk is presumably attenuated by the favorable cardiometabolic profile in women with RA, as suggested by the normal HOMA-IR and atherogenic index.
authors.affiliation: University Hospital of Besançon, Clinical Investigation Center for Biotherapy INSERM CBT-506, FHU INCREASE , Besançon , France ; Department of Rheumatology, University Hospital of Besançon , Besançon , France ; Department of Therapeutics, University of Franche Comté , Besançon , France ; University of Franche Comté, UPRES EA 4266 «Pathogens and Inflammation» SFR FED 4234 , Besançon , France ; LabEX LipSTIC, ANR-11-LABX-0021 , Besançon , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Toussirot
authors.affiliation: University Hospital of Besançon, Endocrine and Metabolic Biochemistry , Besançon , France ; University of Franche Comté, UPRES EA 3920 "Cardiovascular Pathophysiology and Prevention", SFR FED 4234 , Besançon , France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Grandclément
authors.affiliation: LabEX LipSTIC, ANR-11-LABX-0021 , Besançon , France ; UMR1098, INSERM , Besançon , France ; Etablissement Français du Sang Bourgogne Franche-Comté, UMR1098 , Besançon , France ; Université de Franche Comté, UMR1098 , Besançon , France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Gaugler
authors.affiliation: Department of Physical Medicine and Rehabilitation, University Hospital of Besançon , Besançon , France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Michel
authors.affiliation: Department of Rheumatology, University Hospital of Besançon , Besançon , France ; University of Franche Comté, UPRES EA 4266 «Pathogens and Inflammation» SFR FED 4234 , Besançon , France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.affiliation: University Hospital of Besançon, Clinical Investigation Center for Biotherapy INSERM CBT-506, FHU INCREASE , Besançon , France ; LabEX LipSTIC, ANR-11-LABX-0021 , Besançon , France ; UMR1098, INSERM , Besançon , France ; Etablissement Français du Sang Bourgogne Franche-Comté, UMR1098 , Besançon , France ; Université de Franche Comté, UMR1098 , Besançon , France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Saas
authors.affiliation: University Hospital of Besançon, Endocrine and Metabolic Biochemistry , Besançon , France ; University of Franche Comté, UPRES EA 3920 "Cardiovascular Pathophysiology and Prevention", SFR FED 4234 , Besançon , France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dumoulin
keywords: adiponectin; body composition; cardiovascular risk; fat mass; leptin; visceral fat