Insulin-like Growth Factor 1 and Adiponectin and Associations with Muscle Deficits, Disease Characteristics, and Treatments in Rheumatoid Arthritis.
OBJECTIVE
Rheumatoid arthritis (RA) is associated with low muscle mass and density. The objective of our study was to evaluate associations between 2 serum biomarkers [insulin-like growth factor 1 (IGF-1) and adiponectin] and skeletal muscle in RA.


METHODS
Whole-body dual energy X-ray absorptiometry measures of the appendicular lean mass index (ALMI; kg/m(2)) and total fat mass index (kg/m(2)), as well as the peripheral quantitative computed tomography measures of the lower leg muscle and fat cross-sectional area (CSA; cm(2)) and muscle density (an index of fat infiltration) were obtained from 50 participants with RA, ages 18-70 years. Multivariable linear regression analyses evaluated associations between body composition and levels of adiponectin and IGF-1, adjusted for age, sex, and adiposity.


RESULTS
Greater age was associated with higher adiponectin (p = 0.06) and lower IGF-1 (p = 0.004). Eight subjects had IGF-1 levels below the reference range for their age and sex. These subjects had significantly lower ALMI and muscle CSA in multivariable models. Lower IGF-1 levels were associated with greater clinical disease activity and severity, as well as low ALMI, muscle CSA, and muscle density (defined as 1 SD below normative mean). After adjusting for age and sex, greater adiponectin levels were associated with lower BMI (p = 0.02) as well as lower ALMI, and lower muscle CSA, independent of adiposity (p < 0.05). Only greater Health Assessment Questionnaire scores were significantly associated with lower adiponectin levels.


CONCLUSIONS
Low IGF-1 and greater adiponectin levels are associated with lower muscle mass in RA. Lower IGF-1 levels were seen in subjects with greater disease activity and severity.
From the Division of Rheumatology, Philadelphia Veteran Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, and Children's Hospital of Philadelphia, Department of Pediatrics, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics and Medicine, Stanford University, Stanford, California, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; J.M. Von Feldt, MD, MSEd, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania; S. Mostoufi-Moab, MD, MSCE, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania; W. Kim, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; E. Taratuta, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; M.B. Leonard, MD, MSCE, Department of Pediatrics and Medicine, Stanford University. bakerjo@uphs.upenn.edu.
Joshua F
JF
Baker
From the Division of Rheumatology, Philadelphia Veteran Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, and Children's Hospital of Philadelphia, Department of Pediatrics, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics and Medicine, Stanford University, Stanford, California, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; J.M. Von Feldt, MD, MSEd, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania; S. Mostoufi-Moab, MD, MSCE, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania; W. Kim, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; E. Taratuta, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; M.B. Leonard, MD, MSCE, Department of Pediatrics and Medicine, Stanford University.
Joan Marie
JM
Von Feldt
From the Division of Rheumatology, Philadelphia Veteran Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, and Children's Hospital of Philadelphia, Department of Pediatrics, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics and Medicine, Stanford University, Stanford, California, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; J.M. Von Feldt, MD, MSEd, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania; S. Mostoufi-Moab, MD, MSCE, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania; W. Kim, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; E. Taratuta, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; M.B. Leonard, MD, MSCE, Department of Pediatrics and Medicine, Stanford University.
Sogol
S
Mostoufi-Moab
From the Division of Rheumatology, Philadelphia Veteran Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, and Children's Hospital of Philadelphia, Department of Pediatrics, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics and Medicine, Stanford University, Stanford, California, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; J.M. Von Feldt, MD, MSEd, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania; S. Mostoufi-Moab, MD, MSCE, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania; W. Kim, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; E. Taratuta, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; M.B. Leonard, MD, MSCE, Department of Pediatrics and Medicine, Stanford University.
Woojin
W
Kim
From the Division of Rheumatology, Philadelphia Veteran Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, and Children's Hospital of Philadelphia, Department of Pediatrics, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics and Medicine, Stanford University, Stanford, California, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; J.M. Von Feldt, MD, MSEd, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania; S. Mostoufi-Moab, MD, MSCE, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania; W. Kim, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; E. Taratuta, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; M.B. Leonard, MD, MSCE, Department of Pediatrics and Medicine, Stanford University.
Elena
E
Taratuta
From the Division of Rheumatology, Philadelphia Veteran Affairs (VA) Medical Center; Division of Rheumatology, and Department of Biostatistics and Epidemiology, and Children's Hospital of Philadelphia, Department of Pediatrics, and Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pediatrics and Medicine, Stanford University, Stanford, California, USA.J.F. Baker, MD, MSCE, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, and Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania; J.M. Von Feldt, MD, MSEd, Division of Rheumatology, Philadelphia VA Medical Center, and Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania; S. Mostoufi-Moab, MD, MSCE, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania; W. Kim, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; E. Taratuta, MD, Department of Radiology, Perelman School of Medicine, University of Pennsylvania; M.B. Leonard, MD, MSCE, Department of Pediatrics and Medicine, Stanford University.
Mary B
MB
Leonard
D015502:Absorptiometry, Photon / Q000379:methods; D052242:Adiponectin / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D009133:Muscular Atrophy / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D055815:Young Adult
D052242:Adiponectin; D018501:Antirheumatic Agents; D015415:Biomarkers; D007334:Insulin-Like Growth Factor I
ADIPONECTIN; CACHEXIA; LEAN MASS; RHEUMATOID ARTHRITIS